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THE 

PLE'S HEALTH 




ORE COLEMAN 






OlassJLiAli 
Book : 



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COPYRIGHT DEPOSIT; 



THE PEOPLE'S HEALTH 



LOUIS PASTEUR. 

The founder of modern sanitation. Born 1822, died 1895. (Director of Ecole 
Normale, Paris, 1857-1889.) 



THE PRACTICAL SERIES 



THE PEOPLE'S HEALTH 



BY 



WALTER MOORE COLEMAN 



ILLUSTRATED BY RETT A CARROLL, ALFRED SEILER 
AXD WITH PHOTOGRAPHS 



Nefo gork 

THE MACMILLAN COMPANY 

1915 

All rights reserved 



THE PRACTICAL SERIES 

o> 

WALTER MOORE COLEMAN ^ t*^ 

i. PHYSIOLOGY FOR BEGINNERS. x 

2. THE PEOPLE'S HEALTH. 

3. A HYGIENIC PHYSIOLOGY. 



A Health Primer for supplementary reading in third and 
fourth grades belongs to the same series. 

" A First Course in Biology " for high schools by Dean 
L. H. Bailey and Walter Moore Coleman devotes Part III 
to the biology of man. 



Copyright, 1913, 1915, 
By THE MACMILLAN COMPANY. 



Set up and electrotyped. Published July, 1913. Reprinted 
January, 1914; July, 1914; May, 1915. 



fo. 



/V 



NartoootJ $«ss 

J. S. Cushing Co. — Berwick & Smith Co. 

Norwood, Mass., U.S.A. 






PREFACE 

This volume is a o?ie-book (half-year) course in personal, 
JwuseJwld, and industrial hygiene, public health, and human 
physiology. This plan permits the study of the several 
phases of the subject in their close logical relations. This 
is impossible when the branches of health study named 
above are scattered into four or six disconnected books. 
Such books are usually written in a chatty style, mix the 
important and the unimportant, and are wasteful of time, 
effort, and money. Especial care has been taken in reduc- 
ing our recently established sanitary knowledge to a brief, 
clear code. Merely technical and impractical topics have 
been shunned. For example, the details of sewer and 
water systems have been omitted, but every boy should 
know how to make a slope of clay or cement to protect 
springs and wells (Chap. III). 

The author deeply appreciates the kind reception the 
school world has given his other health books, over half a 
million copies of which in a few years have been used in 
the United States, Canada, and England. 

It is believed the untechnical treatment, simple terms, 
and completeness of scope make this book useful in the two 
upper grammar grades and (with shortened time) in the 
high school. The book includes the usual topics in 
teachers' examinations. The illustrations fill ioo pages 
yet they shorten the time for mastering the text and enable 
the pupils to make inspiring stay-at-home trips to inspect 
health activities under many conditions. 

There is a loss of plasticity and lessening of resource- 
fulness brought by mere book study, by memorizing and 



VI , PREFACE 

cramming. On the other hand, to sugar-coat a subject by 
using books written in the diffuse style of popular maga- 
zines and by giving rambling talks, brings an equally 
unfortunate result, for it encourages pupils to be scat- 
terbrained and superficial. Such study unconsciously de- 
generates into a disconnected lesson once a month ; and 
the pupils leave school without a knowledge of how to 
protect their own health or the health of others. The 
writer believes that as useful and important a subject 
as this should not be taught in a loose manner, but that 
the pupils should be held to hard and faithful work. 
Hence the essentials should be brought together in a 
closely knit, orderly way, and studied each day in definite 
lessons. 

Thorough teachers know that they must not only have 
texts which do not confuse the pupil by drowning essen- 
tials in a flood of talk about non-essentials, but that they 
must have books the pupil can understand. Numerous 
qualifications of statements which are true in general, dis- 
courage young students who are trying to get a grasp on 
the elements of a subject. No statement can be made to 
which the captious cannot take exception. Hence the 
author has not troubled the pupil with unnecessary hedging 
of statements. 

Since the blazoning of topics and subtopics tends to 
disjoint the subject and to encourage mechanical study, 
italics have been used for the most important statements 
and key words as they occur in their natural places in the 
text. The italics will serve to guide the teacher's eye dur- 
ing the recitation to the most essential ideas, and save 
time in the framing of questions. 

In an age when individualism has become rampant, the 
discoveries in sanitation have shown that selfishness and 



PREFACE Vll 

indifference to others in matters of health is suicidal. The 
school prepares a pupil for his place in a social community. 
It must not only show him how to attain happiness and 
efficiency, but also help the people of which he is a part to 
become efficient and happy. The author believes in the 
building of character by the school, and that the study 
and the practice of public hygiene will contribute to that 
end. Before the pupil is aware of it he becomes a more 
social being. While studying the needs and rights of 
others, he becomes moved with a desire to help others and 
to respect their rights. 

It is not enough to give knowledge which can be applied 
in daily life ; we must cultivate the habit of independent 
thinking necessary in applying it. As long as many 
schoolrooms are dusty and ill-ventilated, and the death rate 
of teachers from consumption is near the head of the list, 
the school will be handicapped in doing its part in the 
war on tuberculosis and in other sanitary reforms. The 
teacher's clothing, food, gait, posture, exercise, simplicity 
of living, and love of fresh air can aid in hygienic instruc- 
tion as nothing else can. 

An effort has been made to show clearly the relations 
between public and private hygiene ; also the relations be- 
tween rural and urban sanitation. It is hoped the needs of 
neither the city, the town, nor the country have been neg- 
lected. 

The teachers in the country and in small towns will 
receive little help from medical inspectors and health offi- 
cers. They must themselves be the leaders for improved 
sanitation. The teacher need not wait for the appoint- 
ment of a medical officer or school nurse before com- 
mencing effective health work with school children. 

An outline for a brief health census and health survey is 



Vlll 



PREFACE 



Number of Children, Oct. i 
HEALTH CENSUS OF SCHOOL 
Teacher asks questions ; counts hands raised. 



First 
Week 
in Oct. 



First 
Week 

IN 

April 



Gains 

+ , 
Loss — 



10. 
II. 

12. 

13- 

14. 

IS- 



Appetite good, do not miss meals ? 

Seldom take cold ? 

Never drink tea or coffee ? 

Bathe weekly in winter, daily in suirftner ? 

Out of doors, several hours daily ? 

Sleep with windows open ? 

Headache very rare ? 

Pain in eyes very rare ? 

Read writing on blackboard easily ? 

Brush teeth at least once a day ? 

Wash hands before meals ? 

Toothache very rare ? 

Have no corns ? (See Chap. XVII.) 

Do not use tobacco ? 

Sleep eight hours or more daily ? 



1. 

2. 
3- 
4- 
5- 
6. 

7- 
8. 

9- 
10. 



Number of Children, Apr. 1. . 
HEALTH SURVEY 

Actual observations by teacher 

How many have fresh-looking skins ? 
How many sit without cramping the chest ? 
How many write without bending spine to side ? 
How many walk with straight body and full chest ? 
How many breathe with mouth closed ? 
How many are without offensive breath ? 
How many are without " nasal " voice ? 
How many are without coughs, colds, sore throats ? 
How many have loose clothing at waist ? 
How many have no unfilled decayed teeth ? (Use" 
a dentist's mouth mirror with handle.) 



Total points gained by all pupil in six months. 



PREFACE ix 

placed in this preface with blank columns for the teacher's 
use. It is urged that the first of these columns be filled 
at the beginning of the term and that the ambition of the 
school be awakened to make the second census and survey 
show great progress in health. By such work the teacher's 
powers of observation for the physical state of the pupils 
will be greatly increased ; a new sympathy for the weak 
will arise. Most important of all, the pupils will be con- 
vinced that health is not an academic question, but that 
study of it belongs to real life. s 

The teacher will doubtless be surprised at the number of 
children that raise their hands during the first health cen- 
sus taken. An observer in Minnesota finds that eighty per 
cent of the children drink tea or coffee ; twenty per cent 
have frequent headaches ; and forty per cent suffer from 
almost constant toothache. 

After the general survey is made, individual pupils 
should be carefully studied. In the absence of blank 
forms supplied by the department of education or the 
board of health, the teacher should have a notebook with 
one page devoted to each pupil; defects may be noted 
according to the outline in this book (page 210). When 
conditions are discovered which in the opinion of the 
teacher need the attention of the family physician, spe- 
cialist, or dentist, the parent should be so advised. 

The author wishes to thank the following executive offi- 
cers of the several states for important aid while writing 
this book: Eugene R. Kelley, M.D. (State of Washing- 
ton), J. N. Hurty, M.D. (Indiana), Eugene H. Porter, M.D. 
(New York), William F. Snow, M.D. (California), Ralph 
Folk, M.D. (South Dakota), E. F. McCampbell, M.D. 
(Ohio), L. W. Hitchcroft (Statistician, Wisconsin), Morgan 
Smith, M.D. (Arkansas), Warren H. Booker, C E. (North 



X PREFACE 

Carolina), W. F. Cogswell, M.D. (Montana), Calvin S. 
White, M.D. (Oregon), Joseph Y. Porter, M.D. (Florida), 
E. G. Williams, M.D. (Virginia), W. S. Leathers, M.D. 
(Mississippi), H. F. Harris, M.D. (Georgia), G. H. Sum- 
mer, M.D. (Iowa), B. S. Keaton, M.D. (New Jersey), S. G. 
Dixon, M.D. (Pennsylvania). 

He wishes to thank the following gentlemen who have 
read chapters in the manuscript: L. O. Howard, Ph.D., 
Chief of the Bureau of Entomology ; George W. Kober, 
Dean of Medicine and Professor of Hygiene, George 
Washington University; Marion Dorset, M.D., Chief of 
the Biochemic Division, Bureau of Animal Industry ; 
Arthur L. Murray, M.D., Health Department, District of 
Columbia; Allen W. Freeman, M.D., Virginia Board of 
Health; Wickliffe Rose, LL.D., Secretary Rockefeller 
Sanitary Commission. 

The author has received much courtesy and assistance 
in illustrating the book. This he has acknowledged be- 
neath the pictures, and wishes gratefully to acknowledge 
here. He will be glad to receive suggestions for use in 
future editions that every line of the book may be kept as 
clear and accurate as the importance of the subject demands 
and the state of science permits. 



American University Park, 
Washington, D.C, 



CONTENTS 



CHAPTER 
I. 

II. 

III. 

IV. 

V. 

VI. 

VII. 

VIII. 

IX. 

X. 

XI. 

XII. 

XIII. 

XIV. 

XV. 

XVI. 

XVII. 

XVIII. 

XIX. 

XX. 

XXI. 

XXII. 

XXIII. 

XXIV. 

XXV. 

XXVI. 

XXVII. 



Introduction .... 

Fresh Air 

Pure Water .... 

Clean Milk .... 

Pure Food and Pure Food Laws 

Food Values and Economy in Food 

The Prevention of Infection : Human Carriers 



The Prevention of Infection : In 

Hygiene of Work and Play . 

Mental Hygiene 

A Sanitary Home . 

School Sanitation . 

The Public Health Department 

Health and City Life . 

Rural Sanitation . 

Industrial Hygiene 

A Sound Body conquers Disease 

Cells and Tissues . 

Source of the Body's Energy 

Control of the Body 

The Circulation . * . 

The Muscles 

The Skeleton 

The Lungs and 

The Digestion 

The Skin . 

The Senses 



APPENDIX 
INDEX 



Breathing 



sect Carriers 




Courtesy of Indiana Board of Health. 
Having followed the jack-o'-lantern of Cure, and fallen into the pit of darkness, 
they now see the bright stars of Prevention, and resolve to be guided by them. 



THE PEOPLES HEALTH 

CHAPTER I 
INTRODUCTION 

The Athenian's Vow. — " We will never bring disgrace 
on this our city by any act of dishonesty or cowardice, nor 
ever desert our suffering comrades ; we will uphold the 
ideals and sacred things of the city, both alone and with 
many ; we will revere and obey the city's laws and do our 
best to arouse like reverence in those who are prone to set 
them at naught. We will strive to quicken in all the sense 
of public duty. All this will we do that our country may 
become not weaker, but greater, better, and more beautiful 
than when we received it." 

Such was the vow made in the olden time by every young 
citizen of Athens, the most beautiful city of Greece. So 
long as they kept this oath, their country was free and great. 
The children grew up with the most beautiful bodies of any 
people in the world, and those beautiful bodies supported 
the minds of the greatest thinkers, poets, philosophers, and 
artists the world has known. We, as they, are free ; and 
although our country is larger than Greece measured by 
miles, it is really more of a unit than was the small land of 
Greece, for now by means of railways and motor cars, news- 
papers and post offices, telegraphs and telephones, its 
citizens communicate with each other easily and constantly. 



THE PEOPLES HEALTH 



This ease of communication spreads diseases from one 
place to another ; it enables selfish men to send and sell 
to others impure foods and medicines, clothing made in 




The Race with the Sun. 

The railway is one of the inventions which spreads disease and also enables us to 
work together to prevent disease. It makes the whole country almost as one 
neighborhood. 

the homes of diseased workers, and otherwise to endanger 
the public health. But it also enables us, if we will, to 
cooperate in preventing these evils, in helping each other to 

achieve the best things, in keeping 
off dangers to the public health, 
and in making the people healthy 
and happy. 

This book is written to show 
what many noble men and 
women, as noble as those of 
Athens, are trying to do for the 
health and life of all, to suggest 
how each of you may help, and 
to explain the part that you may 
have in your own city or neigh- 
borhood. 

During a recent session of 

Congress, a count of the Senate 

at Washington by one of its members showed that about 

half of the senators were under the care of physicians. 




Miss Jane Addams, who is striv- 
ing for the right of working women 
to have sanitary conditions for 
their work. 



INTRODUCTION 3 

This shows how far our ideals have departed from the Greek 
ideal of perfect living. Such a condition, even of elderly 
men bearing public burdens, could not be imagined in 
Athens among the sane and healthy Greeks. Modern 
people have realized that the number of unsound bodies and 
minds has increased to an alarming extent, and they have 
set about remedying this great evil. This is our patriotic 
duty. A sickly nation is a weak nation. In the war with 
Spain 40 per cent of the recruits at several recruiting 
stations were rejected because of weakness unfitting them 
to be soldiers. 

The large amount of weakness and disease at this time 
should not discourage us, for we are only beginning to 
work at the problem in the right way. To hope to overcome 
disease by cure is simply absurd. It has proven as hopeless 
a task as it would be to sweep back the ocean with a broom. 
Attempting to keep a nation healthy by curing disease 
after it begins will always be a hopeless failure. Preven- 
tion is better than cure. This is practical, reasonable, busi- 
nesslike, and scientific. Even the Chinese, centuries ago, 
learned this and started the custom of paying the physician 
to keep them well and stopping his pay when sickness 
came. Most diseases are preventable ; few are entirely 
curable ; at least the effect of the disease remains in a 
weakened body. We need as many health officers and 
doctors of public health as we need doctors of medicine. 

Although we now pay our physician for helping us to get 
well instead of to keep well, there are numberless men in the 
medical profession who, without pay. are doing all that lies 
in their power to set before the people true preventive meas- 
ures. Perhaps before long the doctor will make regular 
visits when the family is well, uftener in families with very 



THE PEOPLES HEALTH 



young or very old, and therefore delicate members. He 
will foresee and warn against threatened breakdown from 
wrong living. He will notify them of infection in the 




By courtesy New York City Schools. 

Employing a Physician to keep us Well. 

A school doctor testing each nostril of a boy for adenoids. He will look out for 
any other weakness that might lead to illness. 

neighborhood. He will know the family history and know 
what weaknesses to look out for and guard against, and a 
regular salary will be paid him. 



INTRODUCTION 



5 



The people of all civilized countries are slowly coming to 
realize what a costly thing illness is, and what a paying in- 
vestment is money spent for sanitary measures. This is only 
common sense. Just as a boy who takes care of his health 
has lots more fun, so a nation is the happiest when the con- 
ditions of living are most healthful. 

A sickly nation will not only be a weak nation, but also a 
poor one. The working man must guard his health well, for 
it is his only capital. The business man must guard his 
well, because capi- 
tal is of little avail 
without health. 

Hygiene is the 
study of health. 
Health is harmony 
between the body 
and its surround- 
ings. Personal hy- 
giene explains how 
to fit the body to the 
conditions of life. 
Public hygiene 
shows how to fit the 
conditions of life to 
the body. 

In studying per- 
sonal hygiene, and 

especially in studying public hygiene, we are learning how 
to become better citizens. The ignorance of many people 
on health subjects is appalling, and the school is the best 
means of reaching future citizens. With careful instruction 
children will grow up with the knowledge of how to take 




The Dirty Home of a woman who goes daily to 
cook for a clean household, perhaps taking the virus 
of disease. The best way to protect the health of 
one is to protect the health of all. 



6 THE PEOPLES HEALTH 

care of themselves and how " to fight both alone and with 
many," for higher ideals of public health. It will be a 
part of their sense of public duty to do this that they may 
make " their country greater, better, and more beautiful 
than they found it." 

The shocking ignorance of a part of the public is shown in 
many ways. They spend millions of dollars every year 




From Jacob Riis' " The Battle with the Slums. 
An East Side block, New York City. Babies, 500 ; bath tubs, o. 

for harmful patent medicines. They go to " magnetic 
healers " and other humbugs, passing the doors of honest 
physicians who would give them sound advice. If you do 
not believe in magic, why believe the " boasts " of a news- 
paper quack? The only magic about it will be the way 
he gets the money out of his victim's pocket. Sick people 
would not so eagerly accept the rankest absurdities if they 
did not believe in getting something for nothing. They 



IXTRODCCTIOX 



will be less persistent in doing the things that they know 
will undermine the health when they cease to expect a 
magic cure of disease. 77/ health is usually proof of some 
weakness of mind or character. Preserving the health is 
perhaps more a matter of character than of intelligence. 
If the ignorant will not allow the beds of free hospitals to 
remain empty, intelligent citizens are no less inclined to 





(Mm W&ti s 


ft 




f 




" ' 



The baby in this home will not need a public inspector to make the dairy safe. 
Most babies are not so fortunate. 

line up on sanitorium settees with a lot of invalids. No 
more rich men than paupers reach a ripe old age. If one 
expects to accomplish anything in the world, he must learn 
the proper handling of body as well as mind and have the 
strength of will to use the knowledge ; otherwise when he 
seeks health, the character will show its lack of balance 
by the taking up of some health fad. 

Personal hygiene is the first duty of every citizen, but a 
civilized community cannot continue to exist without 



s 



THE PEOPLE'S HEALTH 




public hygiene. If every family milked its own cow, kept 
its own fowls, canned its own fruit and vegetables, taught 
its children at home, caught drinking water from its own 
roof, and neither traveled nor received travelers, there 
would be no need of public hygiene. But no one wants to 
lead so dull and selfish a life. As we now live, an individ- 
ual as an individual cannot protect himself from many 
dangers to health, such as infected milk, foul sewage, impure 
water and air. 

The Structure of the Body. — The structure of the body 
is not as simple as it looks, for it is made of millions of tiny 

parts called cells. Just as the 
walls of a brick house may not 
show at a distance that it is 
made of bricks, so unless we use 
the microscope, the millions of 
tiny cells of which the body is 
made are not visible. We can 
see with our own eyes that the 
body is made of useful parts, 
such as hands, feet, eyes, teeth, 
and tongue. These useful parts 
are called organs, and each has 
a duty to do, called its function. 
The microscope shows us that each organ is made up of 
millions of tiny cells that grow and enlarge by absorbing 
nourishment from the blood. Each cell has a tiny core or 
dot called a nucleus (nu'-cle-us). The organs grow and are 
repaired only by the growth of these cells. When new cells 
are needed for growth or repair, the cell enlarges, the 
nucleus divides into two parts, and the cell divides with it 
into two cells. Each cell is a bit of living substance. 



A house seen at a distance and 
close at hand. 




A boy seen with and without a 
microscope. 






INTRODUCTION g 

Even the blood is composed largely of cells. In its 
plasma, or watery portion, are floating millions of cells of 
two kinds. Most of them are red and round, but there 
are also many of another kind called the white cells, which 
are colorless and of irregular shape. They are larger than 
the red cells, and when magnified look like bits of raw white 
of an egg. 

The white blood cells are the only cells in the body that 
can move about of themselves. By keeping close to the 
walls of a blood tube, they can even crawl along against 
the blood stream. There are many tiny one-celled animals 
that live in w r ater ; and the cell structure of the body, and 
especially the habits of the white blood cells, have suggested 
to some people the theory that the bodies of all large ani- 




Five drawings of the same white blood cell. There are about 000,000 white cells 
in each drop of blood. 

mals like ourselves are descended from tiny one-celled ani- 
mals that lived in the sea millions of years ago ; and that the 
one-celled animals, by living together in colonies and help- 
ing each other, formed larger and more powerful animals. 
For this reason our body likes salt ; tears and sweat are 
salty, and our blood is salty, as you may have noticed when 
you popped your cut finger into your mouth. The blood 
is not as salty as sea water, for the ocean, now that much 
salt has been washed out of the rocks, is much saltier than 
the ocean of that early time. Be that as it may, the cells 
of our bodies do seem like little water animals, for they 
die if dried out. Hence the cells in the outer skin, hair, 



IO 



THE PEOPLE'S HEALTH 



and nails are dead, and we have no feeling when we cut 
those dry parts. 

The cells are like the citizens living together in a city. 
They arrange themselves in tissues and form the organs. 
Since they cannot go to market for food nor to open spaces 
for fresh air, the blood, which is the circulating market of the 
body, brings food and drink and air to them through the 
pipe lines called blood vessels, and takes away used-up 



t/ewce/fr 




Some of the cells, or little fairy people that keep us alive. You notice the cells in 
the windpipe have brooms like little chimney sweeps ; the nerve cells have branches 
for carrying messages. 

rubbish. For these body cells of ours need food, and the 
liquid plasma of the blood soaks out into the lymph spaces 
between the cells to deliver the food. When the watery part 
of the blood gets into these spaces, it is called lymph. The 
food we eat and the oxygen of the air we breathe are carried 
by the blood to the cells ; there the oxygen burns the food, and 
this burning keeps the body warm and makes it strong. The 
cells work even when we sleep ; the blood continually 
carries used-up material to the skin and lungs to be given 
off in breath and perspiration. If you were to weigh 
yourself before going to bed, and again the next morning, 
you would find that the body had lost about half a pound. 



LXTRODCCTIOX II 

Disease Germs. — Health and disease are not mere 
matters of chance. Health depends most of all upon 
following good habits and avoiding bad habits. We may 
weaken the eyes by using them in glaring light or by 
looking too much at very small things ; we may poison 
the blood with alcohol ; we may stunt the growth of the 
body by overwork, or starve it by not giving it the kind 
of food it needs. 

Health also depends upon preventing certain kinds of 
tiny one-celled plants and animals called disease germs, 
from growing and multiplying in the body. It was long 
noticed that certain diseases passed 
from one person to another, but un- 
til the discovery of disease germs 
with the microscope we did not know 
they were conveyed by germs. The 
white blood cells are the tiny citizens 
of the bodily community whose 
especial duty it is to destroy disease Four ™uring B geTs CELLS 
germs, and most valiant little war- 
riors they are. Diseases caused by germs are usually acute ; 
that is, they come suddenly and are quickly over. Diseases 
caused by bad habits are chronic ; that is, they last a long 
time. Acute, or germ, diseases are usually infectious; that 
is. they are passed on by means of germs from one person 
to another. Such diseases as indigestion and kidney disease 
are not infectious. 

Experiments. — Collect specimens of mold, mildew, 
yeast, mushrooms, and other plants without green color, 
and study their manner of growth and multiplication. A 
magnifying glass will be useful. 

Disease germs belong either to a class of one-celled vege- 




12 



THE PEOPLE'S HEALTH 






i 



%» < J a ^ ^^ 



Yeast plants. 



to£fe called bacte'ria, or to a class of one-celled animals called 
protozo'a. The animal germs have various shapes ; some 
have no definite shape at all, but are like specks of formless 
jelly. The tiny plant germs called 
bacteria are shaped like balls, rods, 
and corkscrews (or spirals) ; the germ 
of pneumonia is a ball, or coc'cus; that 
of consumption is a rod, or baciVlus; 
that of cholera is a spiral, or spirillum. 
You no doubt are wondering what 
these bacteria are like. They are not 
like our common plants, since they have neither stem, leaf, 
nor flower, and are not green. They are more like the 
mold which grows on cheese or old bread. 

Green plants flourish in the sunlight; colorless plants 
flourish in darkness. Bacteria are colorless plants ; sun- 
light kills them. They 
resemble mold, but are 
far smaller . The lim i t of 
man's vision is about one 
five hundredth part of 
an inch. We can see a 
speck so small that 500 
like it in a row would 
only reach one inch. 
But it would take 8000 
of the larger kinds of 
bacteria to reach an 
inch, and some are so 
small that probably no microscope will ever enable us to see 
them, although we see their effects in causing certain dis- 
eases. Smallpox is probably a germ disease, but its germ 




Courtesy Dr. Thos. S. Carrington. 
Bacilli of consumption in sputum. 



IXTRODl'CTWX 13 

has never been seen. Most germs are not disease germs, 
but are perfectly harmless. 

Germs ride on particles of dust and droplets of water va- 
por, but left without support they fall freely to the ground ; 
disease germs are seldom found except in places where they 
have been carried by men or animals. 
Most bacteria cannot move, though *ff?7 ' '■' 
some propel themselves in water by $*•* 
means of fine threads. When con- ;'^V** 

ditions are favorable, they increase < ^ ^j •: ' 

rapidly in number. For example, The size of the largest bac- 
a bacillus, or rodlike bacterium, teria compared to the finest 

cambric needle. 

grows in length until it is about 

twice as long as at first, then a partition appears in the 
middle, and two bacilli are formed. When food is lacking, 
some kinds form spores, which may be compared to the 
seeds of ordinary plants. Spores are harder to destroy 
than bacteria. Boiling water kills some disease germs in 
— i one minute, but does not kill their spores. For- 







tunately. most disease germs never form spores. 

A Calculation for the Blackboard: If one germ 
becomes two in half an hour, and these two become 
four in the next half hour, and so on, how many 
germs will be formed in 8 hours ? In 1 2 hours ? 

If disease germs multiply so rapidly, how is it 

possible that any of us survive? Do not get a 

wrong idea. Very few disease germs are harmful to 

a sound, healthy body, and most germs are not 

disease germs, but are helpful to us. 

~fc. If bacteria did not live and work, no 

Wj$i dough would ever rise, no cheese would 



Flies. .flH^^fla-- 



ripen, butter would not have a good 



14 



THE PEOPLES HEALTH 




flavor, the earth would be encumbered with dead plants 
and carcasses, soil would lose its fertility, and the earth 
become a barren desert. The greatest of the many serv- 
ices that bacteria perform is 
Pto convert dead plants and 
.^sm animals into rich soil to sup- 
port new life. 

The best way to prevent the 
growth of harmful germs is by 
fresh air, sunlight, and old- 
fashioned cleanliness ; by soap, 
water, and " elbow grease." 
The food required by man and 
other animals is just the kind 
suited for germ growth. Wild 
yeast germs do not 
attack pure sugar, 
but they may attack diluted sugar in jelly, 
stewed fruits and preserves ; another kind of 
germ may cause meat to taint, another kind 
makes butter rancid. Germ growth is fostered 
by moisture, warmth, and darkness. Hence food 
should be dry and stored in a dry, cool place, 
though it may well be sunned occasionally. The 
skin of vegetables and fruit should not be bruised 
or broken, as the skin protects them from germs. 
Man is the highest animal in the world. 
Germs are the lowest, simplest, and weakest forms 
of life. Man's body can triumph over germs. 
The sounder the body is, the quicker the plasma 
and white cells of the blood kill germs. The cell devour- 

.. - i i i • r • ing a plant 

most important factor in health is the resistance cell. 



What a cellar gave up in 
San Francisco during the campaign 
against rats to stop the plague. 






IXTRODUCTIOX 




A white cell devouring a germ (above) 
and a white cell destroyed by germs 
(below) . 



of the individual. But the little white warriors of the body 

may sometimes be overcome by a very large number of 

germs. Hence cleanliness is necessary. 

The body can kill germs to which it is accustomed, but 

sometimes a germ that the body is not used to gains entrance. 

This is usually because the 

person travels to a new 

place, or because a traveler 

brings in a new kind of dis- 
ease germ. If new germs 

reach the body gradually, 

— only a few at first, — the 

defenders may learn how to 

destroy them. Often the 

struggle between the body and the new germ is so quickly 

over that it is not noticed. Sometimes the body is pros- 
trated by the poisons, or 
toxins, formed by the germs 
while the body is strug- 
gling to acquire mastery 
over them or to kill them. 
It has long been known 
that an infectious disease 
seldom attacks the same 
person twice. You will 
now learn why. 

Pasteur, a Frenchman, 
when studying chicken 
cholera, noticed that if old 
germs from a broth or cul- 
ture of the cholera germs, 
were used to infect chick- 




Courtesy U. S. Dept. of Agriculture. 

A Fowl with Rheumatism. 

This illustrates that when man forces 
indoor inactive life upon domestic animals, 
such a life is as great a curse to them as it 
is to man. (Notice the feet.) 



i6 



THE PEOPLE'S HEALTH 



ens, the disease would be much less severe than if fresh germs 
were used, and the mild disease protected them from having 
the disease in its dangerous form. Such weakened germs are 
called a weakened virus. Jenner, who lived in England long 
before Pasteur was born, had found that cowpox could be 
used as a weakened virus to vaccinate the skin of people. The 
vaccination produced a small sore which protected them from 
smallpox. This method of producing a mild attack which 
protects the animal from catching the disease in its danger- 
ous form is only a way of stimulating the body to form a 
medicine in the blood, called an antitoxin, or antibody, which 
destroys the toxin or poison formed by the germs. Perhaps 
the mild attack also trains the white corpuscles to kill that 
kind of disease germ. Hence we seldom have a germ disease 
a second time. 

We say that vaccination makes the body immune to 
smallpox. Although there are a few enemies of the public 
health who oppose it, this is no vague theory. It has 
been proved in numberless cases. Freedom from liability to 

a disease is called immunity. 
Immunity is either natural or 
acquired. We have natural 
immunity to most diseases of 
other animals, and they are 
immune to most of our dis- 
eases. Our pets do not catch 
scarlet fever or the measles 
when one of the family has 
it. But this is not true of 
all germ diseases. Rats have 
plague, and cattle have a form of consumption. 

To disinfect is to apply chemicals or other means to any 




Sunshine, Nature's disinfectant, the 
best and cheapest. 



LXTRODCCTION 



17 



thing or place for the purpose of killing disease germs. 
Sunshine is the best and cheapest disinfectant. To 
sterilize anything, as water or butter, is to kill all germs and 
spores in it. This is usually done with boiling water or 
steam or by heating. 




it 



tij-i 



Steam and boiling water are used in sterilizing. 

The body not only has the white blood cells with which 
to kill germs, and the tissues to form antibodies that 
render harmless the toxins formed by germs, but the 
saliva and mucus of the mouth and the acid of the stomach 
kill germs, while the unbroken 
skin and mucous membrane 
are germ proof. 

There are both direct and 
indirect causes of germ diseases. 
The indirect causes are bad 
habits which make the body 
weak, so that it cannot resist 

the germs when they attack it. Thus the body becomes 
predisposed to disease by wrong living. The germs are the 
direct cause, but they alone can hardly cause disease. The 
germs of pneumonia and diphtheria are found in the throats 




Hygienic Laboratory, Washington, 
D.C. 



i8 



THE PEOPLE'S HEALTH 



of many healthy people and do them no harm. But these 
people may carry the germs to weak people, who take the 
disease at once. 

Test Questions. — What vow did young Athenians make ? What 
kind of people were the Greeks ? Compare our country and Greece. 
What dangers come from ease of communication ? What is the pur- 
pose of your present study ? Give facts which show that our ideal of 
life is narrower than the Greek ideal. 

What change are we making in attacking the problems of heal th ? 
Why was the old way a failure? What will probably be the chief 
duties of future physicians ? How is health related to wealth ? What 
is health? What is the difference between personal and public hy- 
giene? What can the school do for public hygiene? Give an in- 
stance of public ignorance. What is ill health often a sign of ? Under 
what conditions of life would public hygiene not be needed ? 




Leper colony at Molokai, Sandwich Islands. 



What is the body built of ? What is a cell ? Organ ? Function ? 
Nucleus? How does the body grow and repair itself? What is 
plasma? Describe the two kinds of cells in the blood. Where is 
life supposed to have first existed ? Why are the cells in the hair and 
nails dead ? How do the cells in the body obtain food, drink, and air ? 
What is lymph? What is the source of the body's warmth and 
strength ? What burns in the cells ? Upon what does health depend 
most of all ? Upon what else besides this does it depend ? What is 
infection ? What is the duty of the white blood cells ? What kinds 
of diseases are usually acute and soon over? 



INTRODUCTION 19 

What are bacteria? Protozoa? A coccus? A bacillus? A 
spirillum? Tell the differences between bacteria and common 
plants. What are spores? Give some idea of the rate at which 
germs multiply. Name things done by helpful germs. How is the 
growth of germs prevented ? 

What is the most important thing in preserving the health ? Which 
are more easily vanquished by the cells, strange germs or familiar 
germs? What is a toxin? What did Pasteur find out in studying 
the chicken cholera? What was Jenner's discovery? What is an 
antitoxin or antibody ? Why do we usually not have the same germ 
disease twice? What is immunity? Give an instance of natural 
immunity; acquired immunity. What is disinfection? Steriliza- 
tion? What other protection from germs do we have besides the 
blood and antitoxins ? What two kinds of causes must work together 
to bring about disease ? 



CHAPTER II 
FRESH AIR 

It is feeling that keeps us alive and active and all our 
organs doing their appointed work. The feelings from the 
skin are highly important. The changing play upon the 
skin of wind, of light, of cold and warmth, keep the body active 
and healthy. On a sultry summer day when the air is not 
only still, but almost as warm as the body, we feel oppressed 
and languid, and may even have a smothered feeling. 

From the experiments of Leonard Hill and others, it is 
probable that the bad effects of living in unventilated rooms 

come as much from the warmth 
and moisture of the air as from 
impurities in it. Carbon dioxid is 
the gas that gives the sparkling 
bubbles to soda water ; it is formed 
by the burning always going on in 
the living body, and comes off at 
a simple method^ of getting every breath. This gas (as is 

taught in the two other books of 
the series) is not, in itself, an actively poisonous gas. 
Carbon dioxid does not poison, but it may replace needed 
oxygen, and so the body will suffer for want of oxygen. 
But in unventilated rooms there is usually enough oxygen. 
The harm of such rooms comes partly from the abundance 
of germs and odors from the body, but partly from the 
warmth, moisture, and stillness, — the very conditions that 

20 




FRESH AIR 21 

we find unbearable on a sultry summer day. Even the 
purest air is unhealthful if it is warm, moist, and still. The 
prisoners in the Black Hole of Calcutta (described in Book 
One) died as much from heat stroke as from smothering. 

The sameness of sitting still at work in overwarm, motion- 
less air for long hours, day after day, destroys vigor of 
body and brightness of mind. Most work in factory and 
office is of this kind. The degeneration due to city life 
will be mentioned several times in this book ; but in cities 




Courtesy of Gold Medal Furniture Co. 
Demountable cot with mosquito bar used in camp hospitals of U. S. Army. 

draymen, ditch diggers, and policemen are vigorous and 
healthy because of open-air life. For the same reason city 
horses are almost as sound as country horses ; the air they 
breathe is not like the stagnant air of overheated houses. 
The city clerk, merchant, lawyer, or teacher may take 
the hint, and keep themselves in condition by plenty of 
outdoor or open-window exercise. 

The deepening of basements and subways, the raising of 
skyscrapers which darken the streets, have brought it 
about that many people are " cave dwellers, confined during 
sleeping and waking hours in windless places, with artificial 
light and unchanging warmth." Dwellers in city and town 



22 



THE PEOPLES HEALTH 



no longer have the benefit of struggling with severe weather. 
Only the warm air afforded by tight houses and warm 
clothes reaches their lungs and skin. This is particularly 
true in winter, and it is then that the health becomes bad 
most rapidly. In summer, when the windows are raised, 
scarlet fever, diphtheria, and measles almost disappear. 

Any one who never has to endure cold and hunger be- 
comes soft and flabby and unable to resist disease. It is 




Sunshine and fresh air will keep you young. 



not the cold of winter that brings weakness. The weakness 
comes from overeating and overheating. It is caused 
by the overheated and stale air of factory, school, office, 
public halls, homes, and trains. When the warm house 
and inactive life cause loss of appetite, more seasoning is 
added to the food. What is needed is ventilation by moving 
air, cooler rooms, a part of each day spent out of doors. It is 
worth while to keep a horse healthy and sound ; it is more 
important to keep a man so. Tight, well-built houses and 
warm fires are dangerous comforts. With the poorest 



FRESH AIR 



23 



people conditions are somewhat different, but hardly better. 
Cool rooms require more food and more clothing. The poor 
find that the best way to save food and clothing is to live in 
warm rooms, and that the cheapest way of warming a 
room is by their own breath. In order to warm it in this 
hurtful way, they must keep out the fresh air, which is their 
life, by stopping up every chink and crevice. 

Ventilation is most difficult where people assemble. From 
bad ventilation, people are often sleepy in church. They 




Inside Window Tent, used and not in use. Thus one may sleep in a warm room 
with the head in the open air. For a home-made window tent use two sheets, over- 
lapping and tacked to top and sides of window frame and lower ends tucked under 
the mattress. 



feel faint in crowded halls, listless or fidgety in school, dull 
and heavy in the morning after sleeping in closed bedrooms. 
In crowds, it is the number of germs as well as the sultriness 
that makes people restless. Besides being unhealthful, 
close rooms are uncleanly and unrefined ; they soon have 
a fetid odor caused by particles that are constantly coming 
from the clothes, skin, breath, teeth, and digestive organs 
of human bodies. This odor is depressing and hence un- 
healthful. 

Most people in England are rosy cheeked, partly because 



24 



THE PEOPLE'S HEALTH 



they use open chimneys for warming. Rosy cheeks are 
not so frequent in Germany, where stoves are used, and, to 
save coal, the windows are closed with double sash all 
winter. 

Gold air, cold baths, and cold winds arouse the heart, 
deepen the breathing, increase the heat and energy. With 




Open-air Schoolrooms, Bryn Mawr School, Baltimore. The lungs, the color, 
and the health of these young ladies will be better instead of worse from having 
gone to school. 

exercise, they make the difference between the "soft, 
rotund, overfed city man, and the hard, wiry, active 
farmer or frontiersman." 

Not only the muscles, but the skin and the surface blood 
vessels, the radiators of the body, become weakened by 
constant heat ; the heat regulating power of the body is 
weakened. 

The air of closed rooms heated by hot water and steam 



FRESH AIR 



25 



pipes becomes too dry. A little steam should be allowed 
to escape from a radiator in each room. The air of rooms 
heated by air which has passed over a furnace becomes 
too dry ; unless it also passes over water pans or through a 
spray of water. A large water pan holding several gallons 
may be placed in the air chamber over the fire box. This 
will be enough for the usual-size dwelling, if it is used up 
and the pan refilled daily. A pan of water may be placed 
in each register. Dry 
air dries out the mucous 
membrane of the lungs 
and air passages, pre- 
vents the flow of blood 
through it, and leaves it 
undefended from the 
germs of colds, grip, and 
consumption. 

Red-hot iron and 
loose-jointed stoves, fur- 
naces and pipes, may 
leak a poisonous gas 
called carbon monoxid 
that destroys the red olood cells. To prevent this gas 
the smoke pipe of the furnace should never be closed 
with the damper, and the fresh-air pipe should always be 
open. It should lead, not from the cellar, but from 
outdoors. 

One of the most vicious things ever invented is a pipeless 
gas or oil stove for heating. To burn one for a few minutes 
in a small room, as a bathroom, makes some people dizzy. 
Such stoves give headaches, but kill no one outright, so they 
are used. Gas escapes unburnt from many of the tiny 




Courtesy of Fla. Board of Health. 
Pipeless Stove. If this man has no lung 
disease, he will soon get one. 



26 



THE PEOPLE'S HEALTH 



holes in a fancy " gas log." Open fireplaces are perfect 
ventilators, but much of the heat goes up the chimney. 

It is better to spend money for warm clothing than for 
large fires. Since it is more convenient to add and leave off 
outer clothing with changes of weather or of houses, the 
inner clothing should not be heavy. Cotton is best. A 
perspiring skin under a mass of thick clothing may cause a 
cold. Mufflers cause many sore throats. 




Courtesy of N. Y. Ass'nfor Improving Condition of Poor. 
Where Germs do not Linger. Notice this sash ; two thirds of window open, no 
curtains. No rugs or carpets. 



Frequent colds prepare for consumption. There is 
no surer way to weaken the body and invite a cold 
than to shun all drafts. The stuffy germ-laden air of 
closed houses is the chief cause of colds. Overheating 
causes more colds than cold air. Colds are caused by 
germs ; germs multiply in stuffy rooms ; drafts take them 
away. 

It is certain that in close, unventilated houses many 



FRESH AIR 27 

disease germs adhering to particles of dust in the air are 
carried from one human being to another. 

Tuberculosis. — The germ disease called tuberculosis is 
largely due to living in stale, house air. It has been called 
the scourge of nations, and it is scourging them to return 
to more natural ways of living. Stale air weakens the body 
and may take away the appetite. Indigestion follows, and 
the weak body is unable to resist the bacteria of the disease. 
This germ is called the bacillus tuberculosis ; since it is a 
bacillus, what is its shape? It may grow and multiply 
in the skin and cause lupus ; in the knee joint it causes 
white swelling ; in the glands of the neck, scrofula ; in the 
hip joint, hip-joint disease ; in the spine, hunchback. 
In the lungs occurs the commonest of all forms of tuberculosis ; 
it is there called consumption. 

Tuberculosis is a house disease, for the germ is quickly 
killed by a direct sunlight, and more slowly by ordinary 
daylight. A house in which many consumptives die is 
usually a dark house with few windows. The signs of 
tuberculosis of the lungs, or consumption, are : a cough last- 
ing a month or more, loss of weight, slight fever each after- 
noon, bleeding from lungs, and tired feeling. Habits which 
weaken the body make it unable to resist the germs. Such 
habits are overwork, worry, loss of sleep, drunkenness, 
constant indoor life. Grip, measles, whooping cough, and 
pneumonia predispose to consumption. 

About 20 bacilli are necessary to infect a guinea pig; 
probably 1600 are necessary to infect a calf. It doubtless 
takes as many to infect a man. Thus you see that infection 
is largely a question of cleanliness and of the number of 
germs, not merely a question of contact with one tubercle 
bacillus. Most people are infected without knowing it, 



28 



THE PEOPLES HEALTH 



one or more times during life. Most of them recover, as 
not more than one death in seven is from tuberculosis. 
The healed scars of the disease are seen on the lung of 
nearly every one examined after death. 

No disease improves so rapidly as this if given half a 
chance. This may prove a pitfall; for, after a victim has 
lived right for a time, he gets so much better he thinks he 




Courtesy of Dr. Lee K. Frankel. 
Tuberculosis Sanitarium at Mount Macgregor, N. Y., for employees of 
Metropolitan Life Insurance Company. Thus the company prevents exposure of 
sound employees to infected employees. Notice the sleeping porches. 



is cured, and goes to living in the old way again and the 
disease becomes as bad as before. 

The victim first caught tuberculosis because he did not 
understand the art of right living. Since it is a house dis- 
ease, the patient must live outdoors or in a shed or tent. 
It comes from undernourishment, so the patient must eat 
plain food and plenty of it; the fresh air brings back the 
appetite. 



FRESH AIR 



20 



Drugs are useless. Beware of patent medicines. The 
time lost while using them may be fatal. Perhaps the 
digestion had already been injured by such drugs, or the 
disease would not have begun at all. 

Plenty of sleep and rest for the body and mind will aid 
much. Food, fresh air, and rest enable the cells of the 
body to become strong and win the battle with the germs. 
The surest way is to increase the strength of the body so 
that it will resist and gradually destroy the germs. Con- 
sumption is a disease of filth, carelessness, and intem- 
perance, especially intemperance in alcohol and work 
which keeps one continually overtired. 

With very poor people tuberculosis is a difficult disease 
to cure. Plenty of food and rest and fresh air are the very 
things they cannot afford. If they had not been deprived 
of these, the disease probably would not have attacked 
them. Poverty causes the disease, and the disease in- 
creases poverty by cutting down the earning power. It is 
a disease of bad housing and lack of nourishing food. The 
pale, weary factory worker should move with his family 
to the suburbs before the disease attacks him. One half 
the means spent for cure would prevent having it. Not 
one child in ten among the hard-driven poor of our cities 
is up to normal. Often whole families live in one room 
and rent a corner of it to a boarder so as to be able to pay 
the rent. In slavery times negroes so seldom died of con- 
sumption that the black race was thought to be immune. 
Now negroes in poverty die of it by tens of thousands. 
No wonder that tens of thousands die of consumption 
when millions set up a condition within their bodies 
which invites the disease. 

Every one, and especially consumptives, should resolve 



3° 



THE PEOPLES HEALTH 



that they will not sleep where there is no fresh air, they 
will not work where there is no fresh air, they will not live 
where there is no fresh air. 

There has been somewhat too great a fear of air as a 
germ carrier.- Germs die quickly in light and dry air. 

They thrive in drinking 
cups and closed rooms. 

A consumptive should 
eat plenty of plain food, 
bread, butter, meat, vege- 
tables, eggs, and milk. 
He should never swallow 
what he coughs up. He 
should spit in a sputum 
flask or in paper cups, 
and burn them. He 
should wash his hands 
with soap and water quite 
frequently. He should 
use paper handkerchiefs 
and napkins and burn 
them; if of linen, they 
should be disinfected be- 
fore drying by being 
placed in boiling water. His laundry should be boiled 
before it is washed with other clothing, and his bed clothes 
should* be often exposed to the sun. His dishes should 
not be washed with other dishes. Consumptives would 
oftener get well if they did not repeatedly reinfect them- 
selves. One way to do this is to swallow the sputum. 
The consumptive himself is almost harmless, and only 
becomes harmful through careless habits of himself or 




Courtesy of John A. Kingsbury. 
Sterilizing the Consumptive's Dishes. 
Nurse giving instructions. 



FRESH AIR 



31 



associates. Only one consumptive in three is careful unless 
required to be so. The Brompton Hospital in London is 
for advanced cases of tuberculosis, but 
only two nurses in 90 years have taken 
the disease. 

A new tenant should never move into 
a house where a consumptive has lived 
until it has been disinfected and aired. 
If there has been more than one case, cut 
new windows to increase light and ventila 
tion. Clean sheets in sleeping cars should 
fold back two feet over the blanket, which 
may have been sprayed the night before by a coughing 
consumptive on his way to a hospital. 

The bacilli are scattered by droplets of saliva which leave the 
mouth in line, invisible spray or tiny floating bubbles when 




Dr. Knopf's spu- 
tum flask. It can 
be boiled. 




Courtesy of X. Y. A.ss'n for Improving the Condition of the Poor. 

A fresh-air bedroom. Every city apartment should have a balcony. Notice the 
proper fire escapes on the next houses. 



3 2 



THE PEOPLES HEALTH 



a consumptive coughs, sneezes, sings, or talks forcibly. Hence 
he should cough or sneeze with a handkerchief held in 
front of the mouth ; he should never speak with force while 
his face is turned directly toward any one near him. There 
is much danger from droplet contagion, and less from dried 
germs floating in the air. A handkerchief held over the 
mouth while coughing is to be put at once into the " hand- 
kerchief pocket," which 
is waterproof and remov- 
able. Every one should 
be kind and helpful to 
the careful consumptive 
— there is no need to 
shun him. Like the 
Athenians, we should 
" never desert a suffer- 
ing comrade." 

One tenth of children's 
cases of consumption are 
believed to come from 
cow's milk. Cream to be 
used for butter and ice 
cream, and milk for 
babies, should be sterilized. Child labor in factory and 
study in unventilated schoolrooms prepare the body for 
tuberculosis. 

Consumption cannot be inherited. Being a preventable 
disease, it should be prevented. The death rate from 
consumption has been reduced one third in a few years. 
Isn't that encouraging? But it isn't half as well as the 
people of our country are going to do. Let us " obey the 
laws and stop those who are prone to set them at naught " ; 




A Sleeping Porch built by a poor work- 
man at the cost of a few dollars. Any up- 
stairs porch is a sleeping porch if desired. 



FRESH AIR 



33 



report all cases to the health officer ; disinfect every house 
where a case has been, and burn the rugs and carpets ; give 
treatment and relief to poor consumptives ; protect their 
families ; provide trained nurses to instruct cases in the 
early stage when cure is so easy ; and do what we can to 
educate the public in fresh-air doctrines. 

Camping in the woods and sleeping on porches have a 
value no one can explain. Color soon returns to the cheek 




Sleeping on the porch, Raybrook Sanitarium. 



and the sparkle to the eye. Living indoors practically 
the whole winter is a serious wrong to a growing child. A 
Frenchman has given three health rules for children : i . 
Let them be in the open air. 2. Encourage them to go into 
the open air. 3. Make them go into the open air. Warmth 
is weakening, and cold is strengthening, yet moving to a 
warmer climate often restores a delicate child to sound 
health because of the open-air life. Not only the lungs, 
but the skin, suffers from indoor life. The delightful feeling 
when riding, walking, motoring, or coasting against the 



34 



THE PEOPLE'S HEALTH 



wind is caused by the air reaching the skin through the 
clothing. Not only constantly changing air, but constantly 
changing temperature, is necessary for health. 

Windows are the best ventilators, even though the clothes 
and fuel cost more when they are opened. The draft from 

the window may be broken 
by a board. Ventilating 
shafts and systems usually 
do not work, and none of 
them are " fool proof." 
Of course, no draft even 
of pure air which takes 
more heat from the body 
than the body is making, 
is good for long. " Coal 
is cheaper than colds." 
Even a tent can be made 
snug and warm enough for 
those who dress right. 

Colds are caused by 

overeating, indoor life, 

lack of exercise and cold 

air, wrong clothing. To 

prevent consumption, so 

live as to avoid colds, and 

so dress as to set free the 

lungs for perfectly natural 

breathing. A sunken chest or small waist means less 

breath, poorer blood, less resistance to strain or disease, 

and a shorter life. 

A person who breathes right will hardly have consump- 
tion. A large part of the wastes of the body must go out 




Outside Window Tent as seen from the 
inside and from the outside. 




A Health Resort in Front Yard (above) and Back Yard (below). 

The lady is a policy holder of the Metropolitan Life Insurance Co. which lent 
the photo. Lower photo, lent by Emmanuel Church, Boston. The man is now 
well and at work. The "fly " sheet protects his tent from sun and rain. 



FRESH AIR 



37 



through the lungs. We breathe 15 times a minute because 
we need to take in fresh air and send out impurities 15 
times a minute. Oxygen keeps the rire of life burning. 
Fresh air costs nothing ; that may be one reason people 
are so careless about having plenty of it. Another reason 
is that we used to think that malaria was in night air ; now 
we know it is brought by 
mosquitoes. They used to 
close the bedroom windows 
at night to keep out damp 
air, but the dampest air of 
all is the breath we send 
from the lungs and confine 
in a closed bedroom. Per- 
haps another reason for 
closed rooms is fear of 
burglary. 

The man who always 
sleeps in stagnant air is LvMPH Glaxds in armpits and groins 
slowlv killing himself. These a, -f Uttl , e forts with garrisons of 

" white cells to keep germs from entering 

Note on White Blood Cells. — the blood - Lymph glands are also in 

„.,..„. , the neck, and they swell when there is a 

Tubercle bacilli protect them- fight with germs " from vile teeth> tonsils> 

selves from the white blood cells or nose. 

by forming a waxy coating or 

tubercle. There are several kinds of white blood cells. Some of 

them have more than one nucleus ; these cannot eat the wax. But 

the white blood cells with one nucleus eat the wax and then eat the 

helpless bacilli. 

In other cases when the bacilli have entered the body the white 
cells surround them on all sides, imprison them, hinder their growth. 
The bacilli defend themselves by inclosing themselves in several 
skins. Then the white cells deposit lime in these protecting skins, and 
the bacilli, imprisoned in the tubercles, soon die. 

Note on Natural Immunity. — The most advanced (but not nec- 
essarily more reliable) students of tuberculosis now hold that if human 




38 



THE PEOPLES HEALTH 



bodies were examined minutely enough at death, one or more centers 
of living bacilli would be found in nine tenths of them; they hold 
that most babies become infected, perhaps from crawling on the 
floor and the habit of putting everything in their mouths. Probably 
by the age of six, nine out of ten are tubercular, and remain so through 

life. The tubercle bacilli 
which usually live in a 
lymph gland serve to 
vaccinate the body and 
immunize it, as the slight 
amount of poison they 
pour into the system 
stimulates the produc- 
tion of antibodies to 
protect it from further 
harm. Hence he who 
resists his own tuber- 
culosis is incapable of 
being infected unless he 
should chance to receive 
large numbers of poison- 
ous bacilli at one dose. 
Savage races are very 
susceptible to tubercu- 
losis, because their pure 
manner of life has not 
exposed them in infancy 
to germs which might 
have rendered them 
immune. 

Measles and whooping 
cough have bad records 
for breaking down the 
patient's resistance, but it is believed that typhoid fever is by far the 
commonest predisposing cause of consumption. 

Even when immunity is at its lowest, the bacilli have to fight for 
every inch of ground. The body stubbornly resists and limits nar- 
rowly the area of disease. Months or years may pass before bacilli 
in the sputum and other symptoms of active consumption appear. 
Sometimes tuberculosis appears so promptly after typhoid that the 
physician may think he should have called it tuberculosis from the 




On the porch in cold weather at the Raybrook 
Sanitarium. Collecting consumptives in sanitoria 
is the best way to prevent new cases. 



FRESH AIR 



39 



first ; but probably he had made no mistake — one disease merely 
ran into the other. We can now explain Hazen's Law, that when a 
bad water supply increases typhoid fever, the tuberculosis death rate 
also rises. Pure water diminishes not only typhoid, but tuberculosis 
as well. Those who show signs of tuberculosis should probably not 
submit to vaccination against typhoid, as the efforts of the body in 
forming antibodies against the typhoid vaccine, may weaken its 
resistance to hidden tubercular germs. 

Sanitation has been the cause of the long-continued decrease in the 
tuberculosis death rate, for every epidemic of measles, typhoid, etc., 
which is prevented also 
prevents the tuberculosis ^'~ V1 *V 

which would have followed (f Jrwj 
it. As people learn how 
to live, they avoid the 
things which destroy im- 
munity. A real anti-tuber- 
culosis crusade must be 
directed against everything 
which injures us. Hygienic 
living, by keeping the gen- 
eral health on the highest 
plane, not only strengthens 
our immunity to consump- 
tion directly, but helps us 
to resist other infections 
which might indirectly 
weaken our immunity to 
consumption. 

Jews, other Asiatics and 
brunettes in general, have 
stronger immunity than 

those of blonde European races; for the Baltic and blonde races 
are not used to confinement and hot air. Even Asiatics and Jews 
fade away with consumption if they crowd together too much. 
Hot sick rooms should become a thing of the past. Frontiersmen in 
their log cabins with many cracks in the walls escape consumption. 

The telltale scars and nodules shown by nearly all post mortem 
examinations prove that, at some time, tuberculosis began to spread 
and was conquered. Probably at the beginning of the indoor life of 
the race, the consumptive bacillus first became poisonous, and at first 




Both are preparing the way for consumption. 
Too much clothing and too little. The point of 
the lungs just under the collarbone is the chosen 
seat of consumption. 



4° 



THE PEOPLE'S HEALTH 



only infants died of consumption. Most deaths now are from the 
ages of 1 8 to 85. The race has become so immune that our bodies 
resist the ever present enemy for 70 years and only yield when ex- 
hausted by wear and tear. One fourth of all old people die of pneu- 




A Sanitary Drinking Cup. Fold a clean square sheet of paper five times as 
shown by above guide. Tuck fourth fold as directed. 



monia after having carried the germs of pneumonia around with 
them for 75 or 90 years. 

Test Questions. — What is the effect upon the body of constant 
changes in air and warmth? Why is living in unventilated rooms 
harmful ? What is the effect of motionless air and unchanging tem- 
perature upon the health? Describe the homes of the modern " cave 
dwellers." What is the effect upon the body of freedom from struggle 
and hardship ? How must a city man live to preserve his health ? 



FRESH AIR 4r 

Why do the poor close their rooms tight in winter ? Why are there 
more rosy cheeks in England than in Germany? How may dryness 
of air be prevented in steam-heated houses? In furnace-heated 
houses,? How does dry air injure ? What is the effect on the body 
of carbon monoxid ? How may this gas be prevented ? What is the 
effect of a pipeless gas or oil stove? What advice is given concern- 
ing clothing in cold weather? What is the chief cause of colds? 

What are the causes of tuberculosis? Name several forms of it. 
What kind of a house breeds tuberculosis? What are the signs of 
consumption? What habits lessen the power to resist it?, Why is 
cleanliness important in avoiding it ? Give the clear proof that con- 
sumption is a very curable disease. Where should a consumptive 
spend most of his time ? How should he live ? Why is cure difficult 
for the consumptive poor? Show how consumption and poverty 
affect each other. What should a consumptive eat? What is said 
about a consumptive reinfecting himself? When is a consumptive 
not a danger to others? What precautions should be taken to pro- 
tect others ? What advice is given to a new tenant in a house where 
there has been consumption? 

What is said of droplet contagion? What is a "handkerchief 
pocket"? Tell of childhood and consumption. Is consumption 
inherited? What are the facts about lowering the death rate from 
consumption? Discuss outdoor air and consumption. What sug- 
gestions are made concerning ventilation? How does the author 
attempt to explain the aversion to fresh air ? Have you read the 
note on white cells, and on natural immunity? 



CHAPTER III 
PURE WATER 

To be suited for drinking and use in the home, water 
must be without color, odor, or disease germs, and no deposit 
should form when its stands for a time. 




Courtesy of Eugene R. Kelley, Board of Health, State of Washington. 

A River that supplies Water to a City. These closets should have water- , 
tight boxes, the contents should be disinfected, hauled away, and buried. Those 
who regard the public welfare will not pollute streams. 

42 



PURE WATER 



43 



Impure water is the cause of three fourths of typhoid 
fever, and of much other preventable illness. The question 
of getting pure water is a question of being willing to spend 
the money or go to the trouble necessary to obtain it and 
protect it. 

Since impure water is a chief source of disease, a com- 
munity should take no chances with their drinking water. 
Yet throughout the land people are needlessly drinking 
impure water. If some one would guarantee to protect the 
whole family from water-borne diseases upon payment of 
$5, the father would jump at the offer and reckon it a 
bargain. Yet for $5 in taxes from each family, the water 
supply of any city can be ren- 
dered free from disease germs. 
For a few dollars, or by one or 
two days' labor, the spring or 
well on the farm may be made 
safe. 

It is wasteful for the nation 
to rear children to maturity 
only to have them stricken 
down with preventable diseases 
due to sewage. One city which 
had not done so for the sake of 
sanitation, purified its sewage 
because it was infecting oys- 
ters and ruining the oyster 
trade. This of course helped 
others besides those who ate 
the oysters, but meanwhile the 
health of many had suffered. 

With growth of population, defilement of water is on the 




A Babbling Brook, yet human 
waste from an outbuilding washes 
into it with every rain. 



44 



THE PEOPLE'S HEALTH 



increase. New factories bring defilement to our rivers and 
lakes more and more, until many of them are too foul for 
household use, for bathing, or even for boating. The fish 
in them die. One can readily understand this who has 
ever stood on a river bank below a town or city and watched 
a sewer pouring in its corrupt mixture. 




Courtesy of Metropolitan Water and Sewerage Board. 



Wachusett Dam and Power House. Water is running over the spillway. 
Water is here stored for the citizens of Boston and seventeen other towns. Do 
you waste water at your house ? Have you ever visited or studied the source of 
your water supply ? 



People often dig a cesspool and a well in the same yard. 
The well is usually near the house for convenience, but the 
purity of the water is endangered by the household wastes, 
the pig pen, the cow stable, horse lot, hencoop, and slop 
ditch. The well drains the earth in every direction for at 
least ten times its own depth. Hence the importance of 
a drain pipe to carry off household wastes. If the water 
supply is doubtful, boil the drinking water. 



PURE WATER 



45 



Typhoid bacilli die in polluted water more quickly in 
summer than in winter, being killed by the strong sunlight. 
The typhoid rate per 100,000 in the 50 largest cities of the 
United States is 25. In 33 chief cities of northern Europe 
it is 6^, or about one fourth as high. 




Sunlight kills germs in water, but if there is a tree near, the cistern should be 
covered because of birds and leaves. It should be mosquito proof and have a faucet 
on level of window sill or porch. Rain is the purest water. 



The sources of water supply are rain, springs, wells, 
rivers, and lakes. Rain water properly stored in cisterns 
is safer than well water. Gutters should be kept clean, 
and the water turned into the cistern only after the rain 
has washed the dust off the roof. Underground cisterns 
sometimes crack, and, when the water in the cistern is low, 
impure water seeps in from the soil. 

Springs should be well protected from surface drainage. 
Stables, pigpens, and outhouses should be downhill from 
the well and not nearer than 150 feet, as the underground 
lines of seepage may not slope with the surface. Cement 



46 



THE PEOPLE'S HEALTH 




Courtesy of Va. Board of Health. 



A Spring unprotected and protected from sur- 
face washings. 



should surround the mouth of the well for 5 feet, as 
shown on page 48. Otherwise impurities may wash in. 
A closed well with a pump is better than an open well, 

for, if there is a stable, 
manure from the feet 
may wash into it and 
dirt from the hands may 
fall into it. The well 
rope and well bucket 
should not be handled 
with unclean hands. 
Wells are usually for- 
bidden in towns of over 
10,000 people. 

Rivers and lakes receive dangerous germs from cities, but 
most of them die within a few hours or a few days. The 
Seine River contains no disease germs 43 miles from Paris. 
A lake is a natural reservoir. The water for cities, as Boston 
and New York, is usually stored in great reservoirs and 
purifies itself of germs by standing. 

No one can have typhoid fever without taking into the 
body germs from the body of another person. These germs 
cannot enter the drinking water unless there has been 
carelessness in caring for the body wastes of others. 

Lowell is 1 2 miles above Lawrence on the Merrimac River. 
Both towns drink river water. Lowell pumped wastes 
from the bedchambers of typhoid victims into the river 
and an epidemic of the fever broke out in Lawrence. 
Lawrence began to filter the water, and the death rate in 
general dropped 7 per 1000. 

Change to pure water decreases the deaths from tuberculosis, 
pneumonia, diarrhea, and other diseases, especially diseases 



PURE WATER 47 

of infancy. Drinking good water undoubtedly strengthens 
the body so that it can fight off disease germs. Professor 
Mason says that in Hawkinsville, Ga., chills and fever were 
common. But a change from surface water to artesian 
water for drinking and the household, almost freed the town 
of malaria. The white cells no longer had to fight water- 
borne germs, and were able to concentrate attacks on germs 
brought by mosquitoes. 

Freezing may not kill typhoid germs. Place the ice be- 
side the vessel of drinking water — not in it — to cool it. 
Besides danger of germs, ice in the water makes it so cold 
that it irritates the stomach instead of quenching thirst. 

The common house filter is unreliable. It is usually 
no more than a strainer. 

The earth is a great filter because near the surface it 
contains many useful bacteria that destroy disease germs 
and vegetable matter in the surface drainage. But if the 
cesspool is dug below the few feet of depth at which they 
live and work, disease germs may pass unhindered into the 
well. If the mouth of the well is protected by a proper slope 
and by cement around the curb to a depth of several feet, 
the soil will have filtered and purified the water that may 
leak through the curb lower down. 

Before going into public bathing pools, bathers should 
take a shower bath. Hypochlorite of lime may be applied 
twice a week to kill all germs in the bathing tank. 

Every wide-awake town that has no artesian wells is look- 
ing out for its future growth by acquiring areas necessary 
to protect the watershed surrounding its storage reservoir. 
Los Angeles has laid an immense pipe 130 miles and tunneled 
through two mountain ranges to reach a water supply. When 
a city uses river water, there are usually three parts to its 



48 



THE PEOPLE'S HEALTH 



water reservoirs : i. Settling basin. 2. Filter beds (usually 
covered). 3. Receivers for the filtered water. It would 
be useless to give the details of the great sand filters such 
as sanitary engineers have learned to construct ; such filters 
are not mere strainers. When the water passes through at 




wAT^n' 



An unsafe well ; surface water will 



Va. Health Bulletin. 
The concrete prevents 



A safe well with high 

seep through the cracks between the platform and water- water from reaching the 

upper stones before the good germs tight curbing, but the curb until it has filtered 

have a chance to destroy the dis- ground should slope through several feet of 

ease germs. away from the well. earth. 

a rate of not more than four inches in an hour, a gelatin- 
like growth containing helpful bacteria forms on the top of 
the bed of sand and by it all harmful bacteria are killed 
and the water purified. 

The details of sewage disposal in cities must also be left 
to sanitary engineers. The drains from" private houses 
lead to larger drain called sewers. If the sewers empty 



PURE WATER 



49 



into the river and the water supply is taken from the river 
there is as much disease as if there were no sewers. The 
sewage may be pumped to sewage farms ; garbage may be 
burnt. 

Typhoid Fever. — The bacilli of this disease attack the 
lining of the small intestine, but it is also a blood infection 
and may take the form of pneumonia. Though it is very 




A Well surrounded with concrete to prevent 
seepage, with a chain pump that stirs and aer- 
ates the water. (From Ogden's Rural Hygiene.) 



A Well that catches seepage from trash 
pile, an outdoor closet, and a stable. 



common, it is one of the most easily preventable of diseases. 
Usually the first step in conveying it is pollution of the soil. 
Slops containing the spittle or the discharges from the 
bladder and bowel of a patient are thrown out without dis- 
infection and the next rain may wash the germs into 
drinking water. The germs may seep into a well, or slops 
from the sick room thrown upon a hillside may wash into 
a river or lake from which the water supply of a city is drawn. 



5° 



THE PEOPLE'S HEALTH 



The danger of infection through the milk supply will be 
explained in the next chapter. 

There are walking cases of typhoid which never take to the 
bed. There are many persons now perfectly healthy who 
once had the disease and have remained " typhoid carriers." 
Many of them carry the germs in the gall-bladder and void 




Teaching girls to swim, a part of the course in New York City schools. 



them through the intestine, thus spreading the infection 
for many years, or all through life. The problem of how 
to prevent infection by carriers has not been solved. 

In Europe, where the sanitary code is stricter than with 
us, the death rate of the disease is only one third that of 
America. But one city in the United States (Asheville, 
N.C.) was without a single case of typhoid fever for six 



PURE WATER 



5 1 



months in 191 2, and there was no death from the disease 
during the whole year. 

The bacterium of this disease (the bacil'lus typho'sis) is 
shaped like a thick, short rod, and it possesses threads 
which, in a liquid, may wave and move it along. 

The disease is treated chiefly by careful nursing. Only 
liquid food is given. If solid food is given, even after the 




Courtesy of N. Y. State Health Board. 

Filtering began in 1902. When was the death rate nearly 100 per 100,000 ? 
When was it less than 5 ? 4 

patient is recovering, it is almost certain to cause a relapse 
which will probably be worse than the first attack. 

It is largely a country disease, for it is easily spread in the 
country by soil pollution, which contaminates the water, milk, 
or uncooked food. The germs are then taken in through 
the mouth. In some cases the germs are carried by flies 
directly from the discharges of patients to food. Oysters 
grown in a body of water receiving the drainage of a city 
may contain the germs and infect those who eat raw oysters. 



5^ 



THE PEOPLE'S HEALTH 



The virus from a patient may easily defile cooking utensils, 
drinking cups, and bed linen. The discharges from a patient 
should be disinfected with chloride of lime (6 ounces to i 
gallon of water). They should never be thrown out in 
the neighborhood of springs or wells. These precautions 
should be taken for some time after recovery, for the 
germs may continue in the discharges for a long time. 

If, as sometimes happens, the one who nurses the patient 
also cooks for the household, the greatest care is necessary. 



BEFORE 

SAMITAilY PR1YY LAW 

SEWEE 
DIST, i ! 



DRY CLOSET 

DISTRICT 



typhoidHJH 

CASES I 



TYPHOl 
CASES 




AFTER 

SAfflTABY PRIYY LAW 

SEWE1 
DISTRICT 



DRY CLOSET 
DISTRICT 



TYPK . - ' 

CASES 



1 - I 

CASES 



TOTAL CASES 1910 
329 



TOTAL CASES 1911 
158 

Courtesy of Florida Board of Health. 

Jacksonville, Fla., Chart, showing the effect on typhoid cases of a sanitary privy 
law. Was the effect more marked in the dry closet or sewer district ? 



The nurse and patient should frequently wash and disinfect 
the hands. All dishes from the sick room should be sterilized. 
The ordinary washing of cups and saucers has little effect 
in killing germs. They may be killed by allowing dishes to 
remain for a few minutes in boiling water, or by washing 
*them in water at 120 to which soda has been added. 

Even walking on ground polluted with human waste, 
as in the back yards of some dwellings, and then standing 



PURE WATER 



53 



upon or beside an insanitary well, has resulted in polluting 
tlie water of the well. 

Vaccination to prevent typhoid fever has proved a great 
success in the armies of France, Great Britain, and the 
United States. Among 57,000 United States troops vacci- 
nated, only twelve cases occurred. Before vaccination, 




Courtesy of Maj. F. F. Russell, U. S. Army. 

Army Surgeon Vaccinating a Soldier against typhoid. The 
vaccination is usually done three times. 



there were several hundred cases a year in the army. In 
vaccination, 500,000,000 dead germs are used. 

In the war with Spain in 1898, typhoid fever was very 
fatal. We lost four men from this or other diseases to one 



54 



THE PEOPLE'S HEALTH 



from bullets. By the time of the war between Japan and 
Russia in 1904, sanitation had rapidly advanced, and Japan 
lost only one man from disease to fourteen from bullets. 

In the time of a typhoid epidemic eat only thoroughly 
cooked food ; boil drinking water and milk of uncertain 
origin ; do not fail to wash the hands before eating ; make 
all cesspools and closets fly-tight and perfectly sanitary. 

There are 175,000 cases and 16,000 deaths yearly in the 
United States from the disease. Most of these could be 



Waier Table, 










^#Ss^M#lM# 






Spiring 



Two Water Tables or surfaces of underground water. Where should a well 
be dug ? Where would little water be found ? No water ? 




prevented by thorough sanitation. Drying will quickly 
kill the germ, for it is a very delicate one, and unless it is in soil 
or in a liquid, its life outside of human bodies is short. 

The colon bacillus resembles the typhoid bacillus. It is 
always found in the intestine of man and beasts, and is 
usually harmless. It may become hurtful and cause 
diarrhea when the intestine gets into a vile condition, or a 
more virulent race of the colon bacilli may gain access 
to it. 



Experiment. To make a Paper Drinking Cup. — The teacher 
may distribute clean sheets of paper a foot square in size. The 
pupils may make cups, following the guide on page 40. The cups 
may be kept in envelopes in the desk for daily use. 



PURE WATER 



55 



Cottage 




A drain that pollutes a spring. (Ogden's Rural Hygiene.) 



Test Questions. — What qualities should drinking water have ? 
What part of all typhoid fever cases is caused by impure water ? What 
is the connection between money and a pure water supply ? Why did 
a certain city purify its sewage ? Is pollution of water decreasing or 
increasing? Why? Where should a well not be located? State 
precautions about water of springs ; cisterns ; wells. Does water in 
livers and lakes purify itself? Give the experience of two cities 
on the Merrimac River. What diseases decrease when pure water is 
used ? When is ice water dangerous ? What is said of home filters ? 
Of the earth as a filter? How are public bathing pools purified? 
What is done by wide-awake cities to guard the future water supply ? 
How do large filter beds purify water? 

Explain how typhoid germs may get into the water supply? What 
is meant by a "typhoid carrier"? Describe the typhoid bacillus. 
Why is it easily spread in the country? What insect may carry it? 
What precautions should be taken to prevent a case from infecting 
others ? How may a well become infected ? Has vaccination against 
typhoid been a success ? Is the germ easily killed ? What is said of 
the colon bacillus ? 



CHAPTER IV 
CLEAN MILK 

Experiment i. Dirt Test for Milk. — Get samples of milk from 
several sources. Put absorbent cotton or filter paper in a funnel and 
pour a quart of milk through the funnel. Replace the used cotton 
with exactly the same amount of unused cotton, and pour in a quart 
of another sample. Grade the samples in cleanliness (good, fair, 
bad) according to the whiteness of the cotton. 

Experiment 2. To Test Pasteurized Milk. — Pasteurize half of a 
quart of milk (see text) and let it and the unpasteurized pint set for 
12 hours and compare their condition. The simplest and least ac- 
curate way to pasteurize milk is to place the bottle in a wooden rack, 
set this in a tin pail, pour into the pail enough boiling water to come 
to the level of the milk in the bottle, cover the pail with a lid and allow 
the pail to stand on a wooden table for 30 minutes. At once place 
the bottle in a cool place. 

Experiment 3. To make a Refrigerator for the milk bottle (see 
pages 57 and 67). 

Experiment 4. Test for Preservatives in Milk. — Set some of 
the suspected milk by the side of an equal quantity of reliable milk. 
Notice whether it is unusually slow in souring and spoiling. If so, 
it may have been treated with formaldehyde or other preservative. 

It is easy to obtain clean milk in the country. People 
can look after their own cows or buy fresh milk from a clean ' 
neighbor ; and the milk is used within a few hours before it 
turns sour. How to obtain clean milk in cities is a hard 
problem. It comes from sources unknown to the user, and 
may have been a long time on the journey. 

Milk is made to curdle and turn sour by bacteria which 
change the sugar of milk into lactic acid. Fresh, clean milk 

56 



CLEAN MILK 



57 



starts out with about 2500 bacteria in a cubic centimeter 
(about 15 drops). These will increase in a day to 500,000 
or more if the milk is lukewarm. 




Courtesy of Henry Pliipps Inst., Pliila. 
The Baby's Refrigerator. 

At 40° F., bacteria in milk multiply very slowly. 

At 50 to 6o°, bacteria in milk multiply slowly. 

At 75 to ioo° bacteria in milk multiply very rapidly. 

The lactic acid, or milk-souring, bacteria are not so ob- 
jectionable, but a great number of them show there may 
likewise be many disease germs present. The sale of 
milk is usually not allowed if it has over 
500,000 bacteria in a cubic centimeter. 
They are so unthinkably small that a half 
million is not a large amount. The highest 
grade milk should not contain over 30,000 
bacteria in a cubic centimeter. 

Some hygienists object to boiling milk as it kills all the 
milk-souring bacteria, turns some of the milk sugar into 
caramel, and as milk, boiled, mav cause constipation. It 






The milk-souring 
bacillus. 



58 THE PEOPLE'S HEALTH 

is the custom to use boiled milk for babies in Europe. Since 
it does not form as tough curds as unboiled milk, it is in 
that way more digestible. Boiled milk is distasteful at 
first. To prevent a tendency to produce constipation and 
scurvy, fresh vegetable juice (of orange or grape) is used 
when babies are fed on it. 

Sour milk, or clabber, has been recommended as a health 
drink, since a moderate amount of lactic-acid bacteria is 

believed to be 
healthful and to 
kill injurious bac- 
teria in the human 
food tube. Many 
people, seemingly 

' \ '&ft$#Jffi$?$5 t « , # determined not to 
a b '&&]&&#$&$&& be sensible on 

health subjects, im- 
(f^^W,yti£' S ' mediately based a 

Effect of Temperature upon Growth of Bacteria. SOUf-Mllk fad upon 

a, A single bacterium ; b, its progeny in twenty- this tact, and ex- 
four hours in milk kept at 50 ° F. (5 bacteria) ; c, its _. m, , 

progeny in twenty-four hours in milk kept at 70 F. pectea SOUr milK 10 

(750 bacteria). (From Bulletin 26, Agricultural Exp. jQ^g up for all the 
Station, Storrs, Conn.) ^ . 

shortcomings of an 
unhealthy life. They could stop the breeding and feeding 
of hurtful bacteria in the intestine if they ceased to. over- 
eat. Then they would not need to set good bacteria to 
kill the evil ones. 

There are usually a few bacteria in the udder of the 
cow ; but sour milk is old milk and there are other kinds of 
germs that may multiply in milk. These are putrefactive 
bacteria and other germs of disease which may get in the milk 
from the cans, from dust, and the hands of milkers. 




CLEAN MILK 



59 



One case of typhoid fever in every six is caused by unclean 
milk. Other diseases which may be brought by milk 
are scarlet fever, diphtheria, tuberculosis (perhaps 3 or 4 per 
cent), summer complaint, and other diarrheas of children. 

The bacteria in dirty milk manufacture toxins while 
multiplying in the milk, and will continue to do so after 
they are swallowed. While older children and adults may 




Courtesy of Bureau of Animal Industry. 

Bad Care at Home causes much of the mis- Good Care at Home ; a glass 
chief from bad milk. (Bottles uncovered and over the mouth of each bottle. The 
near stove, crowded room.) refrigerator often aired and sunned. 



recover from attacks of diarrhea caused by these poisons, 
they are often fatal to infants. The effect of dirty milk on 
babies is dreadful. In an epidemic of cholera in Liverpool, 
300 bottle-fed babies died against 20 breast-fed — 15 
times as many. Of 2000 fatal cases of diarrheal diseases 
in infancy, 1940 were bottle-fed. Bacteria grow slowly in 
cold weather, but in the summer the milk in the baby's 
bottle may be swarming with bacteria. Hence the great 
frequency of infant diarrhea in summer has given it the 
name of " summer complaint." Infant mortality due to 
bad milk is preventable and is a disgrace to civilization. 

In Stamford, Conn., 526 persons had typhoid fever in 
two months. Nine tenths of these got their milk from one 



6o 



THE PEOPLE'S HEALTH 



milkman who supplied only one eleventh of all the milk 
used ; two weeks after closing his dairy, new cases ceased. 
In 1908, in Georgetown, D.C., 55 persons contracted 
typhoid who drank the milk handled by a certain dairy 
maid. She was in perfect health but had had typhoid fever 
eighteen years before, and was still a carrier of typhoid 



' 


.-■■ 


1 


"J^3jj|g*B#v' 


SB 


if 

1 


1 

i 





Courtesy of U. S. Bureau of Animal Industry. 
Dirty Cans and Bottles. A closed bottle is better than a dip tank, but a clean 
tank is better than dirty bottles. Milk should be paid for according to cleanliness 
as well as richness of cream. 



germs. Up to 1907, twenty-three outbreaks of typhoid 
were spread by milk in the United States and Great Britain 
in twelve years. 

Some dairymen say: " Why this fuss about clean milk? 
My babies use the milk of my cows and thrive on it ; why 
can't the city babies also? " But the farmer's baby has 
fresh milk. Such milk shipped to the city and examined 
24 hours later may be quite different. It may be spoiled 



CLEAN MILK 61 

and even moldy, and no housewife would buy such stuff, 
but the masses of germs and mold are hidden because 
milk, unlike water and glass, is opaque (that is, it stops 
the passage of light). 

Water is sometimes added to milk and sometimes it has 
been taken from infected wells. Cream is sometimes 
removed and the milk still sold as whole milk. In St. 
Louis about 1600 gallons of cream were removed each day 
— $900,000 worth a year. The children of the poor were 
the chief victims. 

Coins are found in milk bottles, put there by the unclean 
hands of a customer of yesterday, — proof that the bottle 
was used again unwashed. Some peddlers with dip tanks 
hold the measuring can with the thumb inside the can so 
that he not only sells the space occupied by his thumb each 
time, but a few germs besides. Some farmers have filthy 
barns or milk houses or use filthy methods. 

Some dairymen need to study cow hygiene as well as 
human hygiene. To force them to give great amounts 
of milk, cows have been overfed and protected until 
they are abnormal. Few cows live long nowadays. 
Except in 'the South where the cattle are outdoors almost 
the whole year, cows are kept in close barns in winter and 
suffer for want of fresh air and exercise. Some cows have 
tuberculosis, which may be given to babies through the 
milk. Their udders may be inflamed inside or out, and 
pus germs thus reach the milk. Cows which are not in 
good flesh and condition should be examined by a surgeon. 
Tuberculin serum is used in testing cows for tuberculosis. 

The cows must not only be healthy, but they must be 
clean when milked. Their tails should not grow so long 
as to reach the ground. With the use of a brush and of a 



62 THE PEOPLE'S HEALTH 

cloth and warm water, the flanks, sides, and udder should be 
thoroughly cleansed ; and the cow, held by a throat latch or 
chain under the neck, should not lie down again until 
milked. The use of small-mouthed milking pails keeps out 
about half the germs which would have fallen in during the 
milking. Typhoid germs may get into milk before it 
leaves the dairy farm. Sometimes the person who milks 
the cows has a mild " walking case," and the germs upon his 
hands are washed by the milk into the pail. The milker 
may be in good health, but may have just come from the sick 
room where he has nursed his wife or child and failed 
to wash his hands. The milk cans may have been washed in 
contaminated water. Clean overalls and jumper should 
be put on at milking and removed just after and kept in 
a place protected from dust. The milker's hands, above 
all else, must be thoroughly clean. 

Dirty farmers lower the average quality and keep down 
the price of milk and butter, and thus cause a loss to their 
clean neighbors who send milk to the same dairy or same 
market. They injure the whole milk industry, and cause 
many mothers to use canned infant foods and condensed 
milk. 

The cow stable should be in a dry, well-drained place. 
It should be well lighted and ventilated with windows on 
the sides away from cold winds. Muslin may be stretched 
over window openings in cold regions in winter. If openings 
are screened in summer to protect from insects, the cows 
will give more milk. The ceiling should be of matched 
planks to prevent chaff and dust from sifting down from 
the loft. If the walls are unpainted, they should be 
whitewashed twice a year. The walls and ceiling should 
often be swept down and kept free from dust, manure, and 




Courtesy of U. S. Bureau of Animal Industry, Washington. 

Cows Wading through mire and muck. Such conditions prepare the way for 

tuberculosis. 



■■1 


: 


J ~r^-*zjaft 


{"S?S 


■ 3WT- *%> 


* =aft«— **-. 


c££ ^J * ; . 1 -^ 1 auL 



From Jo/in Spargo'.s Commonsense of On Milk Question. 
Cows that need washing. Notice the unclean flanks. 




A dark, dirty stable which held 17 cows although there was only room for 6. 




An Unclean Cow Barn, dark, dusty, and undrained. 



CLEAN MILK 



65 



cobwebs. There will always be some dust, and each pail 
should be removed as soon as filled. The floor should 
be water-tight. Cement is damp for the cow's feet, and it 
should be waterproofed while it is being made ; or water- 
proof bricks or rammed clay may be used for the floor. 
An open drain should pass in front of the stall. Manure 
should be removed twice daily. 

A clean dairy man will furnish clean milk under hard 
conditions ; a slovenly dairy man will furnish unsanitary 
milk from the finest model dairy ever built. Cows should 
not wade in muck, 

;1{.W!*"M.H Hi ]l : M l f * 1 * li 



V 



til I J 



.J I J JJ J I > hill 

1m 1 1 jiijiiLiiiii 




How many times as much dust falls into the 
large-mouth as into the small-mouth pail ? 



but should spend 
most of the time in 
a clean pasture or a 
graveled yard. 

The milk which is 
soon to be used by 
the farmer's own 
family can be kept 
cold in a spring or in 
an " iceless refriger- 
ator " (see chapter on Food). Few springs are cool enough 
to preserve milk for a long time. Milk to be shipped 
should be cooled with ice to 50 F. or less within an hour 
after it is milked. Ice is needed as much for the milk as 
boiling water or steam is needed to scald and sterilize the 
milk vessels before using them. It is an advantage when 
the milk is delivered on a milk route by a wagon direct 
from the dairy farm. Milk becomes more unsafe every 
hour after it leaves the cow. When the distance is greater 
and it goes by rail, it waits for hours at stations and junc- 
tions and is from 16 to 60 hours old when it reaches the door. 



66 



THE PEOPLES HEALTH 



Sealed packages are safer than a dip tank. Milk should 

be bottled at the dairy, not at 
the customer's door. Dipping 
spatters milk on the hands or 
bottles and it runs back into 
the tank . ' l Typhoid carriers ' ' 
should not sell milk, nor follow 
any occupation which places 
them in contact with food 
products. 

When milk reaches the con- 
sumer's home it should not 
stand on the doorstep in the 
hot sun for an hour but it 
should be cooled at once. 
In the summer months heat 
weakens the babies and multi- 
plies the germs. Cholera in- 
fantum and other diseases of 
the stomach and bowels are 
greatly multiplied. One fifth 
of the babies die before they 
are four years old. 

Babies die (of summer com- 
plaint) because the mother or 
sister or servant does not 
clean the nursing bottle and 
milk vessels thoroughly. No 
rubber tube should be used 
in the bottle, but a wide- 
mouth bottle and nipple. 
After use these should be 




Open Pail Small Top Pail. 



Bacterial cultures from milking into 
two kinds of pails. Set of plates from 
open pails shows larger number of 
colonies, a proof of unclean milk. 
Courtesy of Exp. Station, Univ. of Wisconsin. 



CLEAN MILK 



67 



washed thoroughly in cold water, then with hot water and 
soap. They should be scalded again just before use. If 
there is illness, the bottles from the dairy should never 
be taken into the sick 
room and should be 
disinfected after they 
leave the house. Milk 
is a fine food for bac- 
teria and flies carry 
bacteria ; keep the 
flies out of it. 

To make the Baby's 
Refrigerator. — Place 
in the center of a box. 
a pail, or a strip of 
tin curved into a 
circle ; fill in between 
the pail and box with 
sawdust. Place the 
ice and milk bottles 
in a smaller covered 
pail and set it inside 
the first pail. Pad 
the cover of the box 
with many thick- 
nesses of newspapers 
to keep out the heat. 

When it has been 
impossible to keep the milk cool from the time it was 
drawn from the cow, the souring may be delayed by 
pasteurizing it. This is done by heating the milk to 150° 
to 160 F. and keeping it at that temperature for 20 minutes, 




Courtesy of Bureau of I dustri/. 

Sanitary Milking. The milkers wear white 
suits that are kept in a clean place when not in 
use. Buy from the dairyman that takes the 
trouble to have things right. (Pail scalded, cow 
groomed, milk bag wiped, hands washed.; 



6S 



THE PEOPLE'S HEALTH 



stirring it meanwhile. It is then promptly cooled. A 
simple method is given in Experiment 2. Pasteurizing 
will not give it the cooked taste of boiled milk, nor make 
it less digestible, since not all the good bacteria are 
destroyed. 

To pasteurize milk use a tin pail containing water, and 
having a hole in the cover. Set the bottle of milk in the 
water, heat for 20 minutes, keeping it at 155 F., testing 

temperature with ther- 
mometer. Spores are 
not killed by the pro- 
cess and will multiply if 
the milk is allowed to 
get warm again. Pas- 
teurizing does not de- 
stroy the toxins which 
may have already been 
formed by germs. The 
process kills as many 
good germs as harmful 
germs, and even more. 
If disease germs reach 
the milk again they will 
multiply more rapidly in pasteurized milk than in raw milk. 
Pasteurized milk must therefore be carefully protected 
from contamination in air-tight bottles and kept cool. 
Pasteurization must be used only until it becomes possible 
to get absolutely safe milk. It is better to keep down 
bacteria by cleanliness and cold than to destroy them by 
heat. 

Condensed or evaporated milk will not rot in one day 
in hot summer weather as dairy milk will do if not kept 




Courtesy of Amer. Mus. of Natural His. 
Pasteurizing milk (thermometer, rack for 
bottles, a tin pail). 



CLEAN MILK 



69 




cool, but condensed milk is less nourishing. When properly 

diluted it contains less than half as much cream as cow's 

milk, and only two thirds 

as much solid food. It is 

sometimes weaker than the 

milk sold by the notorious 

dairyman whose favorite 

cow was the well pump. 

Some manufacturers make 

extravagant claims for infant 

foods sold in paper boxes. 

These foods may be little 

better than starvation diet. 

The remedy is to regulate 

the milk supply so as to 

have clean, fresh, whole 

milk. 

Inspection is necessary, both for dairies and salesmen, 

and both before and after permits are issued. Clean 

milk and healthy children cost less than cheap milk and 

doctors' bills. Milk that costs 
less per quart may cost much 
more before the summer is 
over. Clean milk is worth 
more as a food than dirty milk, 
for the sugar and casein, or 
cheesy part, have not already 
served as food for bacteria . The 
consumer should treat the 
producer fairly by paying 

Cans. The vessels are placed with m ore for good milk than for 
mouth down to keep out flies and dust. 

The house is not near a pigpen. bad. Fair treatment of the 



Courtesy of U. S. Agri. Depl. 

A Sanitary Cow House. Notice the 

feeding-trench, stanchions, windows that 

open, spots of light on the pavement from 

the ventilators above. 




70 THE PEOPLE'S HEALTH 

consumer means prosperity for the producer. Inspection 
is necessary for cleanliness. In Berlin, one of the best 
inspected cities, it is estimated that 300 pounds of barnyard 
filth are consumed in milk each day. The mixing of one 
dirty quart with a thousand clean ones contaminates 
them all in the same way, but much more rapidly, than a 
few rotten apples will spread the germs of putrefaction 
and destroy the whole barrel of apples. 

The public will be fed with butter, cheese, cream, and 
ice cream made from dirty milk, or the milk of diseased cows, 
as long as it does not object vigorously. The movement for 
pure milk is largely a crusade to help the helpless little 
folks, and preserve their ruddy cheeks, healthy bodies, and 
little lives. 

In some cities, inspectors grade milk in three classes: A, 
certified ; B, selected ; C, ordinary inspection. Grade A 
is for use of infants. Grade B has been filtered, placed in 
bottles or cans, and sterilized by steam. It is safe milk. 
Grade C, used in restaurants, and hotels for cooking and for 
ice cream, should always be pasteurized before use, as 
otherwise it is unsafe. Cans containing it should be painted 
red (for danger) on the neck and shoulder. 

Test Questions. — Why is a supply of clean, fresh milk a harder 
problem in the city than in the country ? At what temperatures do 
germs in milk multiply very slowly ? Slowly? Very rapidly? What 
is the bacteria count allowed in some cities for the worst milk sold ? 
The best milk? 

Discuss the use of boiled milk ; the sour milk fad. Name germs 
of disease that may get into milk. Why may milk be dangerous even 
after all germs have been killed? At what age- of life, and at what 
season of the year, is milk most dangerous ? Give the facts about the 
typhoid epidemic in Stamford, Conn.? Georgetown, D.C. ? What 
is sometimes added to milk? Taken from it? In what ways may 
milk become contaminated? 



CLEAN MILK 73 

How may cows be made unhealthy ? Describe the management 
of cows and other methods in a clean dairy. Why are dirty dairy 
farmers a burden to other dairy farmers ? Describe a sanitary dairy 
barn. Explain the care of milk after it leaves the barn. 

What precautions with the, baby's milk must be taken by the 
nurse ? How is the baby's refrigerator made ? How used ? What is 
pasteurization ? What are its advantages and disadvantages ? How 
is it done ? What is said of condensed milk ? Artificial infant foods ? 
Why does clean milk contain more nourishment than dirty milk? 
Why is good milk cheaper in the end ? What is the most important 
reason for guarding the milk supply ? How is milk graded ? 

Illustrated Studies. I. It will prove a welcome change of method 
to send pupils to the blackboard, each to draw and explain one of the 
following figures: pages 9, 10, 13, 15, 23, 25, 34, 37, 39, 40, 45, 46, 
48, 51, 54, 55, 57. 58, 65, 81, 83, 84, 89. 

II. Chap. I. Describe the face of Pasteur, discoverer of bacteria. 
If Prevention is a guiding star, what may Cure be likened to ? How 
may railroads affect public health? Describe the face of a noted 
friend of workingwomen. How test whether a nostril is open ? Test 
each of yours. How may dirt in a poor woman's home affect a clean 
home? Are all the rooms in the East Side block, N.Y. City, in reach 
of light and air? What is the shape of liver cells? Nerve cells? 
Muscle cells? Yeast plant? Tubercle bacilli? When is a cellar 
a menace ? (One half the cellar air reaches the rooms above.) What 
may result from keeping fowls shut in? Chap. II. Describe two 
cots for outdoor sleeping. Describe two window tents: p. 23, 34. 
How may the sides of an open-air school be protected when it rains ? 
Describe six ways of sleeping in the open air : p. 26, 28, 31, 32, t,^, 35. 
How may a tent be protected from the heat of the sun ? The damp 
ground? Where do lymph glands abound? Their function? De- 
scribe two imprudent w^ays of dressing. Chap. III. Describe 
Wachusett reservoir. Describe a fit and an unfit cistern. How is a 
spring protected? When has a well an unsafe curb? A safe curb? 
Protection from drainage? Seepage? Is your well so protected? 
(If you cannot obtain cement, use clay.) What was the typhoid 
deathrate in Binghamton, the year before and the year after filtration 
began? Chap. IV. How is a small ice box made? p. 57. Test your 
refrigerator ; it should be 50 F. or less ? How fast do bacteria in 
milk multiply at 50 ? 75 ? Describe good and bad care of milk at 
home. Describe unsanitary dairy conditions: p. 60, 63, 64, 65. 
Sanitary conditions: p. 65, 68, 69, 70. 



CHAPTER V 

PURE FOOD AND PURE FOOD LAWS 

Experimental Tests for Food Adulterations. — The teacher should 
write for Bulletin No. ioo of the Bureau of Chemistry, Department of 
Agriculture. It is well to have samples of food known to be pure, to 
compare with the samples to be tested. Note the cleanliness and 
age of the wrapper or container, the look and feel of the food. 

The following will be needed for these tests : Ferric alum, muriatic 
acid (caution : it will attack skin or clothes or metal, if contact is 
allowed), formalin (solution of formaldehyde), borax, alcohol, tur- 
meric paper, and filter paper. 

Experiment i. Formaldehyde. — (Used to preserve milk, etc.) 
Place i \ ounces of milk in each of two china cups ; to one add 5 drops 
of formaldehyde solution. Now proceed as follows : Add to each lot 
of milk 1^ ounces of muriatic acid and a piece of ferric alum as large 
as a pinhead. Rotate the cup gently so as to mix the acid and the 
milk. Place the cups in boiling water and let stand away from the 
fire for five minutes. The one containing the formaldehyde will 
turn purplish. (See also Experiment 4, Chapter IV.) 

Experiment 2. Copper. — (At times used to give peas or beans a 
bright green color.) Mash up a teaspoonful of the suspected peas 
or beans in a china cup with several teaspoonfuls of water ; add about 
25 drops of muriatic acid and set the cup in boiling water. Place a 
bright iron nail or piece of steel in the cup with the beans, and heat 
the water around the cup for half an hour. If copper is present in 
considerable amount, a red coating of that metal will appear on 
the nail. (Because of effective enforcement of pure food laws, bright 
green peas may not be purchasable ; copper acetate may be added 
to show the test.) 

Experiment 3. Borax. — (Used to preserve meat and fish.) Mix 
a tablespoonful of finely chopped meat with hot water, and rub up 
well ; press through a cloth, and to three tablespoonfuls add about 50 

74 



PURE FOOD AND PURE FOOD LAWS 75 

drops of muriatic acid. Filter through paper, and dip a piece of tur- 
meric paper in the clear solution. Pin the turmeric paper to a board 
to dry. If borax is present, the turmeric paper will turn cherry 
red. (The National Pure Food laws do not allow the use of borax on 
meat. If you have no suspected sample, a small amount of borax 
may be added to meat before making the test.) 

Experiment 4. Genuine Butter, Renovated Butter, and Oleomar- 
garine. — Melt the sample in a tablespoon over a lamp turned low, 
stirring it with a splinter or match. Increase the heat until it comes 
to a brisk boil, stirring it thoroughly. Oleomargarine and renovated 
butter make a noise and splutter when boiling, like grease boiling 
in water, and foam not at all, or very slightly. True butter (unless 
it contains much milk) boils more quietly and produces much foam. 
Dairy butter foams, but does not splutter ; renovated butter and oleo- 
margarine splutter, but do not foam. 

Experiment 5. Canned Goods. — If the ends of a can are swelled 
out, or if gas escapes when a small hole is made, or if the can is leak- 
ing, the contents have spoiled. The contents should not be used. 
When a can is opened, notice whether it is rusted or corroded ; this 
may mean that tin or lead has been dissolved in the food. Pre- 
servatives are rarely found in canned goods. If canned oysters or 
lobsters have the least suspicious taste or smell, a poisonous ptomaine 
may be present. Two solder marks are a sign of spoiled food. All 
cans should be emptied as soon as opened. 

Experiment 6. Vinegar. — If a little grape or apple vinegar is 
nearly dried up by applying heat, an odor of grapes or of baked apples 
will be detected in the part remaining. 

Experiment 7. Vanilla Extract. — This is sometimes adulterated 
with the cheap and poorly flavored tonka bean. By comparing sample 
to be tested with genuine vanilla extract, a difference in odor and 
taste is readily noticed. 

Experiment 8. Eggs. — A " candler " may be made by rolling 
cardboard or stiff paper into a tube 12 inches long and 1^ inches in 
diameter, with one end cut to fit the eye and the other to fit the egg. 
Look through the tube and the egg towards the sun. Study fresh eggs 
first, then examine decayed eggs. A fresh egg appears unclouded. 
If setting has begun, there will be a dark spot, larger as the setting 
is more advanced. A rotten egg appears dark. The white and yellow 
of eggs which have been long in cold storage have a tendency to run 
together when the egg is broken. An egg may be tested by odor and 
taste after it is opened. 



7 6 



THE PEOPLE'S HEALTH 




Straw stack eggs are often musty. 



Experiment o. General Test for Preservatives in canned goods 
and other foods. (See Experiment 4, Chapter IV. These tests are 
made in the same way as the tests for a preservative in milk.) 

The adulteration of food and drink had become such an 
alarming evil that in 1906 Congress passed a pure food law. 

Various states have also passed 
pure food laws. 

Passing a law is a very easy 
matter compared with its en- 
forcement, especially when there 
is large profit in breaking it. 
Much bitter abuse has been 
vented upon those who stand 
for pure food, and strong oppo- 
sition against an officer that 
does his duty is often aroused 
by those whose purses are grow- 
ing large at the expense of the 
people's health'. It is needful 
here, if anywhere, that " we try 
to arouse reverence for the laws 
in those who are prone to set 
them at naught " (page 1). 

Poor people are more liable 
than the rich to be injured by 
• adulterated or spoiled food, since 
they cannot pay high for extra care in maintaining purity. 
Food adulteration is stealing, and most often from the 
needy. Each citizen must do his share in watching for and 
reporting violations of law and upholding faithful officers. 
We are all links in a chain. 

When avaricious manufacturers or dealers add acids 




A laying hen and a sitting hen 
some eggs good and some bad. 




From Egg Circular, Kansas B. of H. 
Hidden nests may contain rots. 



PURE FOOD AND PURE FOOD LAWS 77 

(sulphurous, salicylic, benzoic) and alum to stale food to 
prevent its spoiling ; when they stain peas a bright green 
with a copper compound, or give sweetness to food with 
saccharine made from coal tar to create the impression that 
the food contains wholesome sugar, not only our pocket- 
books, but our health and lives, are attacked. What are 
we going to do about it ? At present, because of the efforts 
of the government, such adulterations have greatly de- 
creased. But there are rascals ever ready to take advantage 
if officers or people cease to be vigilant. 

These enemies of the public good often lose a small part 
of their ill-gotten gains in fines. They deserve imprison- 
ment in addition as a warning to others that the health of a 
people must not be sold for gain. Thus will honest mer- 
chants be protected against cheats, and civic righteousness 
not be a mockery. The first duty of citizens in this matter 
is to see that food inspectors and other health officers are not 
selected because of politics, but for competence, and that faith- 
ful ones are kept in office no matter what party carries 
the election. 

There are three kinds of impure food sold : those which 
have begun to decompose or rot ; those preserved with 
chemicals; those adulterated with cheaper foodstuff. 

Here is a list of the food unfit for use, condemned and 
destroyed by food inspectors in Missouri during seven 
months in the year 191 2 : 20 pounds of candy, 135 packages 
of breakfast food, 741 pounds of meat and fish, 1200 pounds 
of hominy, 125 pounds of spoiled beans, 640 bottles of 
poisonous catchup, 80 cans of unwholesome milk, 134 
bottles of olives, 316 cans of decaying canned meat, 1885 
cans of bad fruits and vegetables. 581 bottles of impure 
patent medicines, and 225,000 eggs. 



78 



THE PEOPLES HEALTH 



Sometimes sulphur is found in dried fruits, candy, 
molasses, wines. Benzoate of soda is sometimes used to 
preserve butter, catchups, jellies, mincemeat, preserves, and 
cider. In canneries it is sometimes used not only to pre- 
serve food, but to preserve green or partly rotted tomatoes 
and berries which are unfit for canning, but which are made 
into a pulp to be used as fillers for pies, preserves, and 
catchup. 







* 


•V- " -- — . - • , * 

L 


m 


1 / , ■ 

IP* 1 *'.". '* : - r 



Courtesy of Holland's Magazine. 
Testing for Adulterations. 



The use of chemicals enables men to stop the decay in un- 
clean trash and sell it as food. Their use is a danger for 
this reason, even if they do not injure digestion. But we 
should remember that whatever chemical protects food 
from decay makes it indigestible for the body. All are 
not agreed on the unhealthfulness of small amounts of 
benzoate of soda and several other preservatives, but it is 
well to give the body the benefit of the doubt, and buy foods 
to which they have not been added. Even if the chemical 
does not poison the body, their use to prevent the spoiling 
of food permits careless methods of handling and manu- 



PURE FOOD AND PURE FOOD LAWS 



79 



f acture, and the use of unsound material. Preserves, jellies, 
and jams are sometimes chiefly made of pumpkin pulp or of 
glucose, colored with coal tar (aniline) dye, preserved with 
benzoate, and labeled with the name of a fruit of which 
they have hardly a trace. Crushed millet and timothy seed 
have been used to adulterate fruit jams. 

Some " apple vinegar " has never been touched by apple 
juice, but is made of acetic acid and colored. Since the 
fruit flavor, not the acid, is the chief part of vinegar of 
benefit to us, such vinegar is a fraud. 

Raisins, dried figs, apples, and currants are sometimes 
wormy or decomposed. Raisins on the bunch are usually 
cleaner, fresher, and better flavored than stemmed raisins. 
Lemon and vanilla extracts may be made of artificial flavors 
and colored with coal tar dyes, but artificial vanilla extract 
is more often colored with burnt sugar. Pure vanilla 
extract is colorless. 

Saccharine, a costly coal tar drug, is said to be 500 times 
sweeter than cane sugar, and hence is cheap to use when 
imitating foods made partly of sugar. It is injurious and 
is not a food, but passes from the body unchanged. Its 
taste is sweet, but it leaves an unpleasant after-taste. 

Cane sugar, or sucrose, costs twice as much as glucose, 
hence glucose is often substituted for it. The glucose of 
commerce is made by treating corn starch or potato 
starch with sulphuric acid. If it is carelessly manufactured, 
it contains sulphuric acid. It is much used to adulterate 
honey, sirup, and preserves. 

Ginger ale often contains pepper instead of ginger, as a 
little pepper takes the place of much ginger and is far 
cheaper. Bottled soft drinks may have an injurious pre- 
servative added to them. Many summer drinks have 



8o 



THE PEOPLE'S HEALTH 



caffeine or extract of cocoa leaf added to them so as to 
produce a craving and increase the sale. They may thus 
lead to a drug habit and break the health. There could be 
no more fiendish scheme to destroy health for the sake of 
gain than to offer a beautifully colored, sweet-flavored, 
foaming summer drink to the thirsty, with a habit-forming 
drug in it to fasten its use upon the victim. 




Courtesy of Good Housekeeping, 381 Fourth Ave., N.Y. 



Cool Drinks are refreshing in summer, but be careful not to choose a drink that 
contains caffeine or other "dope." At some fountains drinking glasses used by 
dozens of people are washed in the same water. (Too much soda water causes gas 
on the stomach.) The cartoon on the next page was also loaned by " Good House- 
keeping." 

Ice cream and cold drinks are pleasant in hot weather. 
They should not be gulped down, but eaten or sipped slowly. 
Cases of poisoning from ice cream may be due to milk 
that had putrefied before it was frozen, or the ice cream 
may have thawed and spoiled and was then frozen again. 
Ice cream cones may be stale or freshened with borax. 
Some people will eat any frozen stuff that happens to look 



ri' RE FOOD AND PURE FOOD LAWS 



8l 



like ice cream, though it may have the flavor of stale 
condensed milk or no flavor at all. Dextrin, starch, 
gelatin, and other things are used for thickening, as their 
cost is a small fraction of the cost of cream, and they require 
less ice in freezing the stuff and keeping it. Dextrin costs 
about three cents a pound. You may have wondered 
why blocks of "hokey-pokey " ice cream do not melt on 
the peddler's cart, even when exposed to the summer sun. 




The\- probably contain no cream and precious little even of 
skimmed milk. The legal standard in most cities requires 
14 per cent of pure cream in ice cream. 

Soda pop and soda water sometimes contain lead from 
the pipes which dissolves very readily ; if so, such drinks 
may cause diarrhea. 

The cold storage of meat and eggs is a practice readily 
open to abuse. Undrawn fowls keep better frozen than 
fowls from which the entrails have been drawn, because 
there are no cut or raw surfaces. They are sometimes 
kept fresh for six months, and are perhaps preferable to 
live fowls so handled in coops as to become thin and fever- 
ish. If fowls and fish are not sold solidly frozen, poultry 



82 



THE PEOPLES HEALTH 



should be sold alive in coops, and fish alive in tanks. This is 
the custom in most countries of Europe. If kept in cold 
storage only a few degrees below freezing, they slowly 
spoil. Those yellow, soft, wet, soggy chickens so often 
sold in city markets do not taste like chickens nor look like 
chickens to a farmer or a dweller in the suburbs who 
raises chickens at home. They may have been soaked in 
water to increase their weight. To save expense of ice, 




Courtesy of Indiana Board of Health, Dr. J. N. Hurty, Sec'y. 
A Sanitary Meat Market, Kokomo, Ind. 

poultry and meat are too often kept on the market till the 
last minute without freezing and then put in cold storage 
after decomposition is beginning. It continues slowly 
during storage and becomes very rapid after removal and 
thawing. Eggs kept in cold storage longer than a month 
or six weeks change their taste and aroma. Such eggs are 
useful only for baking. Hamburger steak and sausage, if 
of a bright red color, have probably been treated with 
sulphite. 

You see the inscription on foods and drugs : " Guaran- 
teed under the U. S. Food and Drug Act, June 30, 1906, 



PURE FOOD AND PURE FOOD LAWS ' 8$ 

serial no. — ." This is merely the guarantee of the manu- 
facturer, not of the government, and is required merely that 

ALLOVR GOODS APE 

HIGHLY ADULTERATED. 

Qur<fl±i>oy$ ztrt harmless si, Is trtofcj 

Copy of a sign on a soda-water stand in Philadelphia. The pure food law requires 
truthful labels but does not prohibit non-poisonous substitution if notice is given. 
To avoid impure food read the labels. Watch for the words : — coal tar, saccharine, 
salicylic, sulphite, benzoate. 

an innocent retail merchant may have the guarantee of the 
original packer or manufacturer if sued for selling impure 
food. But most people fall into the error of thinking that 
it is a government guarantee of the truthfulness of the label 
or the purity of the goods. The 
requirement will probably soon 
be changed so that labels will read 
" guaranteed by the maker under, 

etc " 

^ LC * Trichina (enlarged) in Pork. 

Cleanliness. — Pure food must H atf-cooked pork or sausage is 

unsafe. 

be kept clean and cool, or it will 

soon become as dangerous as impure or adulterated foods. 
Places of manufacture should be watched by officers and 
customers to see that they are clean and that clean, fresh 
materials are used. 

Ice cream may be made of pure cream and sugar, yet it 
will not be safe if it is made in a dirty cellar which is dark 
and unventilated, has a ceiling black and dropping with 
filth and cobwebs and is used, perhaps, as a storeroom 
for old clothing and waste. Yet such places are some- 
times used for bakeries and for making ice cream. Boiling 




84 



THE PEOPLES HEALTH 



water is as necessary for washing ice cream saucers and 
drinking glasses at the drug store, soda fountain, and refresh- 
ment parlor, as in the kitchen at home, yet this is seldom 





OC TOBER 


NOVEMBER A 






DECEMBER 






JANUARY 




/9/0 


j9/o m 






/9/0 






/9'f 




' B * ^cxcvseo C3 ' 


* 80 ^ITcufh S'^l 






*-£s<c<SSE0 *S 










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/9/^ 




S3 FJ£JL,M 


^ ^ - ^^ 


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* 3 £ZZLl>3 


<A 




m tm m __. 



Courtesy of U. S. Bureau of Animal Industry. 

Health Curves at Annapolis Naval Academy. Upper curve for 4 mos. in 
1910-1911 while the school was without its own dairy. These curves show that the 
greatest number ill at one time (more than 60) was in Nov., 1910, and that average 
illness decreased to about one fourth after school dairy was established in 191 1. 

done. They are hurriedly rinsed in a trough under the 
counter ; hundreds of glasses and saucers used by clean and 
unclean, sound and diseased, are rinsed in this trough or 
vat before the water is changed. Food tastes better from 

perfectly clean dishes. 
A telltale odor or taste 
of soap and grease is the 
chief difference between 
a clean restaurant or 
home and one that is 
unclean. Dishes should 
be rinsed after they are 
washed with soap. 
Food and dishes should not be left exposed in pantry or 
kitchen during sweeping, nor uncovered soon after. Molds, 
yeast, and bacteria are much more abundant in the air during 
sweeping, and do not settle from the air for several hours ; 
hence it is better to sweep the kitchen less often, lightly 
brush up bits of trash, and wash the floor every few days. 




Have you ever looked behind the counter in 
your grocery store ? 



PURE FOOD AND PURE FOOD LAWS 85 

Dusting with a cloth to which dust will stick is even more 
necessary in the kitchen than in other rooms. The fur of 
dogs and cats touches many things which we would not like 
to have touch our food. It is more uncleanly to let a dog 
come into a kitchen than into a parlor. They leave loose 
hair and dirt in the house. 

Diseased cooks, diseased dairymen, grocers, or peddlers 
may contaminate food. Notice your baker as well as his 
shop ; does he cough and spit ? 

Honest Measures. — To protect honest dealers and buyers 
a law should require that the weight or quantity be marked on 
every package, can, bucket^ bottle, or measure. A good 
present to a bride who expects to be a home maker would 
be a correct pair of scales. The buyer may be cheated by 
the use of short-weight scales and short measures. Some 
correct scales will weigh incorrectly if the meat is put toward 
one edge, or if the butcher touches it with his hand to 
steady it. Of a hundred bushel baskets tested in a certain 
city market, only five held a bushel. A quart berry box 
may be made to hold much less by pressing slightly on 
the sides. Quart bottles, especially those with rounded-up 
bottoms, rarely hold more than six gills. 

One who steals by the use of false weights and measures 
is liable to arrest and a heavy fine. When a housekeeper 
finds she is being cheated, she may merely transfer her trade 
and hope that others will do the same, and the cheat have 
to stop business. If so, she misses doing a real public 
service. Because of her cowardice in not having him 
arrested when sure that he was cheating, other housekeepers 
will be cheated and honest merchants have to compete 
with a rascal. The housekeeper should also beware of 
merchants who, when reliable goods of known quality 



86 THE PEOPLES HEALTH 

are called for, always offer another kind " just as 
good." 

Marketing; buying for freshness and flavor. — If the 

health department has done its duty and allowed only safe 
foods to be sold, it still depends upon the citizen whether 
the food bought shall also be well flavored and palatable. 
Even if the acid of the canned tomatoes or fruit has not 
dissolved the tin or lead from the solder, canned fruit is 
not so palatable as fresh fruit. Of two foods equally safe, 
it pays to buy, at a higher price, the more palatable one, for 
it will be better digested and give more nourishment. 

Sometimes the flavor of the best food is spoiled in the 
cooking. The writer who suggested that vegetables be 
avoided because most of them have no flavor and have 
to be highly seasoned with salt, pepper, and vinegar, had 
a bad cook or was a stupid buyer. Fresh vegetables eaten 
raw, or properly cooked, have fine flavors. 

Skill in marketing is soon learned. Pods inclosing peas 
should be crisp and plump. String beans should not look 
faded and limp, nor be tough or stringy when snapped. 
Cabbage heads with the dark green outer leaves somewhat 
wilted may be fresher than bright white heads which may 
have had the outer leaves taken off every day or two to 
restore a fresh look until sold. Cucumbers, carrots, and 
turnips should be firm to the touch. Head lettuce should 
have firm, white hearts without the rusty look which tells 
of long keeping. It will keep fresh longer if the root is 
left on. When cabbage is eaten raw, one head will keep 
fresh several days if the outer leaves are not removed, 
but merely turned back while slices are being cut. Green 
corn should have fresh, bright husks, or shucks. If wilted, 
the ears will have little flavor. It loses some of its sweet- 



ri'RE FOOD AND PURE FOOD LAWS 



87 



ness within two hours after being pulled from the stalk. 
This is because its sugar begins at once to turn to starch. 

There are tricks of the trade to give old vegetables a fresh 
look : the wilted outside leaves of celery, cabbage, and 
lettuce are pulled off and the ends of the stems of these 




Courtesy of Nat'l Cash Reg. Co. 



Going to Market. The food is fresh. Stale food has little flavor. Unappetiz- 
ing food causes dyspepsia. This gardening kept the boys off the street. 

vegetables and of melons are cut to show a fresh surface ; 
or their leaves are given a fresh look by being sprinkled 
with water which is not always clean. The tops of beets 
are removed, leaf by leaf, as they wilt. 

In general, when a vegetable is cheapest, then it is also best, 
for this will be its natural season of ripening. Half-grown 
new potatoes are costly and unhealthful. At the time 
when potatoes are very old, they are highest in price ; rice 
and hominy may be used instead. 

The farmer with his wagon, the gardener with his cart 



88 THE PEOPLE'S HEALTH 

or little booth, usually have the freshest fruits and vege- 
tables. The farmers came to market with their wagons 
at Georgetown, D.C., for a hundred years, and there was 
a fine, cheap market. But local dealers wanted to add to 
their profits and keep out competition, and charges to be 
paid by the farmers 'were increased. The market place is 




Courtesy of Nat' I Cash Reg. Co. 
Young gardeners balancing accounts. Their garden is 
on a vacant lot. 

now nearly deserted, and more profits must be paid by 
citizens. This has happened in many towns. 

A standing order may be given a neighboring farmer, 
and delivery made daily by parcel post. A dozen eggs or 
2 pounds of butter or other foods will go by a rural route to 
town for 6 cents, 50 miles for 8 cents, 150 miles for 10 cents. 
Eleven pounds, say a hamper basket, with assorted vege- 
tables or fruits or dressed fowls, will go by rural route to 



PURE FOOD AND PURE FOOD LAWS 



89 



town and be delivered for 1 5 cents ; the producer and 
consumer can thus retain and divide the profits of middle- 
men and peddlers equally, and the food supplied will be 
fresher. This is a general custom in England. The tele- 
phone makes direct dealing easy. 

The freshness of fruits and vegetables is highly important, 
for if fresh they may be eaten without seasoning and will 
purify the blood, 
skin, and complex- 
ion. Highly sea- 
soned, they have 
the opposite effect. 
The acids in fruits 
purify the food 
tube. People who 
eat well-flavored 
food will not often 
feel depressed, and 
their appetites will 
not need other than 
this natural stim- 
ulus. 

The freshness of 
meat may be judged 
by its color, that 
of fish by the color of the gills. " Fish, flesh, and fowl " are 
kept fresh with greater difficulty than vegetables, grain, and 
fruit. How is the freshness of eggs tested ? (Experiment 8.) 

Methods of storing food are worthy of thought. In 
cool weather, fish and meat may be wiped with a damp 
cloth and placed outside in fresh air in a box on the wall 
closed with a wire screen. Bread and cake will keep fresh 




A Window Box for keeping food in contact with 
outside air. Protected outside by wire screen, in- 
side by window, or by curtain when window is raised. 
(Mary Hinton Abel.) 



go THE PEOPLE'S HEALTH 

if well wrapped or kept in a tin box with a tight lid. The 
box will become musty if never sunned and crumbs are 
left in it. Beans and peas may be kept in earthenware 
crocks or tin lard buckets with tight lids. People with their 
own gardens will be able to store their vegetables for winter 
by the following rules : Potatoes are best kept in a cool, dry, 
dark place. Carrots, parsnips, and turnips remain plump 
and fresh in earth or sand-filled boxes on the cellar floor. 
Sweet potatoes may be kept until January if cleaned without 
bruising their skins, dried, and packed in chaff, and not 
touching each other. Pumpkins and squash must be 
thoroughly mature. They should be dried from time to 
time and kept on a shelf, not touching each other. Cabbages 
should be placed in barrels with the roots uppermost. 
Tomatoes may be kept till January if gathered before frost, 
wiped dry, and placed on straw-covered racks in the cellar. 

People who grow and store their own food have a great 
advantage over others. Those without orchard or garden 
may buy in quantity from farmers at the right season and 
store them. 

Rice, currants, and raisins may be kept air-tight in wide- 
mouthed preserve jars. Stone and earthenware absorb fat, 
and meat should not be put in them. The cans containing 
tea and coffee must be kept air-tight or their flavor will be 
lost. Things kept in paper bags attract mice. House- 
keepers who understand sanitation know food must be dried 
before it is stored ; that the cooler food is kept, the better ; 
that to keep out rot, the skins of fruits and vegetables 
must not be broken in handling. They remember that bac- 
teria, yeast, and molds grow best at 8o° to 95 F. and love 
moisture and darkness. They wash the tops of jars, cans, 
and milk bottles to prevent soiling the contents when 



PURE FOOD AND PURE FOOD LAWS 91 

opened. They wash fruit before it is peeled and nuts 
before they are cracked, since they have been iiz ::iany 
hands and exposed to all sorts of dust. They know that 
cold-storage food spoils quickly when brought into a warm 
temperature. They air the cellar and pantry regularly 




Courtesy of National Child Labor Committee, 105 E. 22 St., X.Y. 

Tenement Workers Picking Nuts. They use their teeth on shells that do not 
yield to the finger. Notice the mother has a sore throat. Careful people buy whole 
nuts, not kernels ; lemons, not extract, cocoanuts not desiccated ; breakfast grains 
whole, not crushed or rolled ; raisins unseeded, etc. « 

and, unlike some housekeepers, they do not wait for house- 
cleaning once a year to wash the shelves and floor clean with 
soap and water, carefully dry them, and sun their contents 
meanwhile. 

Test Questions. — In what year was the National Pure Food law 
passed by Congress? Why are there difficulties in enforcing pure 
food laws ? Xame some injurious chemicals used to preserve food. 
How should food inspectors be selected? What are the three kinds 



9 2 



THE PEOPLES HEALTH 



of impure foods? For what is benzoate of soda sometimes used? 
Of what are jellies and jams sometimes made ? What kind of raisins 
are cleanest? What is used to color imitation flavoring extracts? 
What have you learned of saccharine? Glucose? Ginger ale? 
Summer drinks? Ice cream? Soda water? 

What is said of the cold storage of fowls ? The sale of fish ? De- 
scribe an undesirable fowl. What did you learn of cold storage eggs ? 
What is signified by the guarantee label on food and drugs ? What is 
said of places of manufacture? What have you learned of clean- 
liness at soda fountains? What are the dangers of contaminating 
food in a kitchen ? 

What is said of honest weights and measures? What should you 
do when you are cheated ? How is freshness recognized in each of the 
common vegetables? .What is said of city markets? What plans 
are given for buying direct from the farm ? Why is it important that 
food should not only be sound, but fresh ? Give the ways of storing 
foods in cellars, and of keeping foods fresh and clean in the kitchen. 



CHAPTER VI 
FOOD VALUES AND ECONOMY IN FOOD 

Experiment i. Test for Acids. — For acid tests, use sour butter- 
milk (which contains lactic acid) or muriatic acid diluted in ten parts 
water, or strong vinegar (which contains acetic acid). Obtain litmus 
paper at a druggist's. Dip a strip of red litmus and of blue litmus 
paper into the acid. What result? Even dilute acids taste sour and 
make the skin thin. 

Experiment 2. Test for Alkalines. — For alkaline tests, dissolve in a 
glass of water a spoonful of baking soda or some laundry soap. Test 
effect of alkaline solution on red and blue litmus paper. 

Experiment 3. To neutralize an Alkali with an Acid. — Pour some 
of the alkaline solution into a dish, gradually add dilute acid (or sour 
buttermilk), stirring with glass rod and testing with litmus until the 
mixture does not turn red litmus blue nor blue litmus red. The acid 
and alkali are then said to have neutralized each other, and the 
resulting substance is called a salt. If the last experiment is tried 
with soda and sour buttermilk, the demonstration will show some of 
the facts involved in bread making with the use of these substances. 

Experiment 4. Test for Starch. — Cooked starch turns blue with 
iodine. Obtain a few cents' worth of tincture of iodine and dilute it 
in a bottle. Get a half dozen pieces of paper and cardboard, all 
different, and test each for starch by placing it over mouth of bottle 
and tipping the bottle up. If much starch is present, the spot will 
be blue-black or dark blue ; if little starch, pale blue ; if no starch, 
brown or yellowish. Make pastes by boiling wheat flour, potato 
starch, and corn starch with water. Treat a little of each with a 
solution of rather dilute tincture of iodine. Raw starch does not 
turn blue with iodine. 

Experiment 5. Test for Proteids. — Heat white of egg slowly. 
What change takes place in the egg? (White of egg is proteid.) 
Does heat harden or soften most substances? Proteid when burned 
has a characteristic odor of burnt feathers ; this will be noticed if 
lean meat or cheese is charred in a spoon. The offensive odor from 

93 



94 



THE PEOPLE'S HEALTH 



decomposing proteid is also characteristic, whether it comes from stale 
beans, meat, mushrooms, or other things containing proteid. 

Experiment 6. Test for Fats and Oils. — Place a little tallow from 
a candle on unglazed paper and warm. Hold the paper up to the 
light and examine it. What effect has the fat had on the paper? 
Place a little starch, sugar, powdered chalk, or white of egg on paper 
and repeat the experiment : is the effect the same ? Place some of the 
tallow in a spoon and heat. Compare the effect of heat on fat and 
proteid. Water also makes paper partly transparent but the water 
soon evaporates. 

Experiment 7. Human Teeth. — Study the form of teeth from 
every part of the mouth. Get a handful from a dentist. Break 
some of the teeth to make out their structure. Examine decayed 
places. 

Experiment 8. Study of the Teeth. — Sit with the back to the 
light and look into a mirror, with the mouth wide open. Examine 
your teeth for cleanliness and decay. Examine gums. A small 
mirror placed in the mouth will show you the back side of the teeth. 



Economy in Food. — Inspectors may see that the food 
is pure, and you may purchase it fresh and palatable at 

the market, but if you do not 
know the nourishing value of 
different foods, the body may 
not be well nourished, even with 
great outlay of money. 

People sometimes use tea and 
coffee as fancied substitutes for 
real food. Thin soup, which is 
mostly water, has little nourish- 
ment. The nourishing value of 
food is an important question. 
Three fifths of defective children 
suffer from undernourishment. 
This is true, not only among 
ill-fed and rickety. the children of the very poor 




FOOD VALUES AXD ECOXOMY TX FOOD 



95 



who lack food, but also among children of the rich who eat 
so much and so often that they suffer from indigestion. 

You learned in studying physiology and personal hygiene 
for beginners that foods do more than one kind of work. 
There are three classes of foods. There are tissue builders, 
or building foods (proteids), for constructing the body, and 
fuel foods, or coal foods, for keeping it warm and enabling 
it to work. The coal (or carbon) foods are starches and 
sugar, fats and oils. There is a third class, called mineral 
foods, such as iron, salt, and 
water, which helps the proteids 
in building the body. The 
ash that is left after food is 
burned shows the amount of 
solid mineral that was in the 
food. Artificially refined foods 
may cause mineral starvation 
and bring on disease. Refined 
white sugar has only one two- 
hundredth part the mineral 
matter of brown sugar. 

The proteids are flesh-formers 
and they build and repair the 
body. A child needs proteid food in order to grow. If 
a man ate no proteid food he would starve, even though 
he ate plenty of the other kinds of food, for his body would 
wear out and could not be renewed. Examples of food 
containing much proteid are milk, eggs, cheese, lean meat, 
peas, and beans. Beans have been called the " beef of the 
garden." They contain much proteid food, but they also 
contain coal food and mineral food. 

The things which contain more of coal foods than of any 




Composition of hen egg. 



96 



THE PEOPLE'S HEALTH 



other kind are potatoes, apples, bread, and other starchy 
things ; also butter, lard, fat meat, and oily foods. There 
is one kind of tissue in the body which is made chiefly 
from coal foods, and that is fatty tissue. 

To study the value of foods for our bodies, we must 
have an exact unit to measure by. We measure food by the 
units of energy it gives to the body, 
and the unit of energy is called the 
cal'orie. A calorie of energy equals 
the increase of heat in one kilogram of 
water when its temperature is raised 
i° C. A boy of twelve requires about 
1500 of these units of food in a day, a 
housewife, 2500, an outdoor laborer, 
3500. It is useful to be able to calcu- 
late the fuel value which ten cents or a 
dollar will buy. The following list 
gives the number of calories per pound : 



Peanuts 1775 

Peanuts (edible part) . . . 2460 

Sugar (granulated) .... 1750 

Wheat (roller) flour . . . 1635 

Corn meal 1635 

Beef (round) 890 

Fowl . . 795 

Sweet Potatoes 44° 

Milk 310 

Bananas (edible part) . . . 4 00 

Mackerel (fresh) .... 370 

Grapes 295 

Potatoes ....... 295 

Apples ........ 19° 




Farmers' Bulletin 295. 
Make-up of Carrot. 



a, fiber, starch 
sugar, d, proteid 



fat. b, 
e, min- 
eral. Slanting lines show 
food lost in boiling. 



Potatoes must be less than one cent 
a pound, and beef about two cents a 



FOOD VALUES AND ECONOMY IN FOOD 



97 



pound, to be as cheap a fuel food as flour at three cents a 
pound. 

About 12 oz. of lard or 26 oz. of sugar contain a day's 
allowance of 3000 calories. But we must eat mere than 



refuse: 

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Farmers' Bullztin 293. 

Composition of apple, banana, dried fig. The nitrogen-free extract is sugar and 
starch. How do you eat a banana without touching the edible portion with the 
hand ? Those who use judgment in selecting food do not forget fruits and nuts. 



one kind of food, for the body needs food for various pur- 
poses. When more proteid food is taken than is needed for 
repair and growth, it may serve as fuel along with the coal 
foods. The intake and use of fuel should balance. If 
the intake is less, the body is underfed ; if the intake is 
greater than the amount used, the body is overfed. If 



98 THE PEOPLE'S HEALTH 

you are very fat and wish to reduce your weight, do not 
starve yourself, but leave all fats out of the diet. If this is 
not enough, leave out some of the starch and sugar. A full- 
fed man has more energy and vigor than an overfed man 
or underfed man. A pound of peanut butter contains 
far more nourishment than a pound of beef and costs less. 
Another economical food is cheese, yet while the people of 
our land eat in a year only 4 pounds of cheese apiece, they 
use annually an average of more than 100 pounds of meat 
exclusive of poultry and fish. It is habit, custom, or 

PROTON 166 *' fWf|]|p\ I M%MZ%m£ L r~ ,07 ** RR0T£IN 

STAPCH.SUGAB.ETC /X5<*k \ lJU fPw«/ M ^Wt' ~" S * STAfiCHSUGAR.CTC. 

CfiUOEF/BER 26%v^-LjT.A10y/ VM W^^^^ C * U0€ r,0£ * 

Farmers' Bulletin 332. 
Composition of an Oily Nut (walnut) and a Starchy Nut (chestnut). A half 
dozen pecans or other oily nuts eaten daily at breakfast will prevent constipation. 

lack of knowledge which causes a people thus to neglect 
nourishing, cheap, and appetizing food. Pound for pound, 
cheese has more proteid than beef and half again' as much 
fat. 

Which food in the table on page 99 is the cheapest fuel 
food? Cheese, you notice, ranks fourth. You get more 
calories from ten cents' worth of cheese than of milk, and 
about twice as much for your money if you spend it for cheese 
as you do if you spend it for beefsteak. Compare fuel 
values and cost of a pound of beef and a s quart of milk. 
Compare these with the cost and value of a dozen eggs. 

A lunch of bread and milk weighing 16 oz., and costing 
about 8 cents, contains 1080 fuel units of food (calories) ; a 
lunch of soup, beef, potatoes, turnips, bread and butter, 
coffee with milk and sugar, costs 25 cents and contains 865 
food units. 



FOOD VALUES AND ECONOMY IN FOOD 



99 



Amounts of Protein and Energy obtained for io Cents ex- 
pended for Cheese and other Foods at Certain Assumed 
Prices per Pound. 









10 Cents 


>' WORTH 






10 Cents 


WILL CONTAIN — 


Food Materials 


Price 


will 

BUY 










A Fuel 










Value of — 






Ounces 


Ounces 


Calories 


Cheese 


22 cents per pound 


7-3 


1.9 


886 


Beef, average 






20 cents per pound 


8.0 • 


1.2 


467 


Porterhouse steal 






25 cents per pound 


6.4 


i-3 


444 


Dried beef . . 






25 cents per pound 


6.4 


1.6 


3i5 


Eggs . . . 






24 cents per dozen 


10. 


i-3 


198 


Milk . . . 






9 cents per quart 


3*-3 


1.2 


736 


Wheat bread . 






5 cents per pound 


32.0 


2.9 


2.400 


Potatoes . . 






60 cents per bushel 


160.0 


— 


2,950 


Apples . . . 






1^ cents per pound 


106.7 


— 


1,270 



The proteid and coal food of the diet should be balanced. 
Milk, eggs, and meat at the same meal give an excess of 
proteid. Bread, potatoes, rice, and custard at a meal 
mean decidedly too much starch. As it cloys the appetite, 
an excess of sugar should be avoided. Because they cloy, 
sugary foods are usually eaten last. 

Stimulating foods should be eaten sparingly; meat, pie, 
pickles, catchup, and coffee at one meal would not be fair 
to the stomach. " The stomach has to take what you give 
it, but it does not have to digest it." Sometimes it decides 
that one foot up will be less work than thirty feet down. 

A diet may be simple and yet supply the various elements 
needed. It is not necessary to eat a great variety of foods 
to be perfectly nourished, for a single food, as milk, or 
bread or beans or grain, will contain not only one of the food 
elements, fat, sugar, starch, proteid, mineral, but several of 



IOO 



THE PEOPLE'S HEALTH 



them. Indeed the fewer articles of food eaten, provided 
they supply various elements, the better for digestion. 

The Arab on a diet of bread and dates, the Japanese rick- 
shaman . and Chinese coolie who live on unpolished rice, 
and the Italian navvy who lives on macaroni, do as much or 
more work than the British and American laborers on a 
varied diet. 

In primitive ages man had times of feasting, when he 
was successful in the chase, and also times of scarcity and 

CHART SHOWING COMPOSITION OF VARIOUS MILKS. 
WEfl5THiLK 



1 










, 


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fm 1 1 

SU0AR& [!:■*■■■!>■.: "i 
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CO/iD£NS£D MILH 








t , .... . .. , 


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MAHUFBCTURED rooo. 








mm^r- , . 






1 


SRITi NOT 5HOWH 









Which infant food is most lacking in fats? in sugar and 
starch ? Which has most casein ? 



fasting. Christmas and Thanksgiving feasts, in spite of 
what .diet cranks may say, accord with man's natural 
habits formed during long ages ; so do occasional times of 
stint. A great variety of food at the same meal does not 
accord with the history of man's stomach. Savage man did 
not have half a dozen foods before him at once, and nibble 
first one, then another. According to the season, his meal 
was wholly of meat, or of fish, or of fruits and nuts. When 
many different kinds of foods are eaten, the glands must 



FOOD VALUES AXD ECOXOMVLX FOOD 



TO 



furnish different ferments for their digestion. All people 
who reach extreme old age live on a simple diet. Some 
prefer to make one meal every day on fruit alone. 

Many foods, before they are tampered with, have certain 
active principles (or ferments) in them that stimulate and 
help the digestive organs. They are destroyed by great heat. 
There are certain active principles in the outer layers of 




Courtesy of Xac York City Schools. 

Cooking lesson in a vocation school. A good cook is the strongest foe 
of the saloon. 

wheat, rice, and other grains and in milk and meat, which 
are destroyed by heating to 250 F. Food cooked at or 
above this temperature has lost taste and flavor. To try 
to remedy the work of poor cooks by replacing natural 
flavors with vinegar, pepper, mustard, and spices is to make 
the matter worse. Bad food weakens people so that their 
weakened bodies demand ovenvarm rooms, stimulants, and 
narcotics. 



102 THE PEOPLE'S HEALTH 

The more simply foods are prepared and eaten, the 
better. The Greeks ate unleavened bread, made of coarse 
barley flour, fruits, olives, goat's milk, cheese, nuts, radishes, 
green salads (lettuce, etc., with no pepper or vinegar), 
weak wine, honey, fish, and dried figs. 

People who cannot digest boiled potatoes, can relish and 
digest potatoes steamed in their skins ; boiling takes out 




A pile of cotton "in the seed." Cotton-seed cake is a good food for man 
and beast. Cotton-seed oil is with difficulty distinguished from olive oil. 
Unless the olive oil is of the finest quality the cotton-seed oil may have the 
finer flavor. It is likelier to be purer oil than olive oil because of the many 
refining processes in making it. 

valuable mineral salts. There are mineral salts in vege- 
tables and milk which are needed to make the blood and 
bones of a growing child and to sustain the health of 
grownups. Certain mineral salts are required to aid diges- 
tion. 

The unspoiled appetite relishes simple food and does not 
need to be stimulated with seasonings. Bad food does not 
satisfy, and leads to high seasoning and overeating, and 
overeating is the chief destroyer of good appetite. 

The craze for whiteness in bread is a fruitful cause of bad 



FOOD VALUES AND ECONOMY IN FOOD 



103 



health. Some merchant or miller advertised a certain 
brand of wheat flour as whiter than all others, and thus 
caught the fancy of good ladies whose heads were able to 
hold only the idea that whiteness meant cleanliness. Other 
millers were driven likewise to throw out the brown part of 
the grain containing lime, iron, and phosphates. Then others 
began to bleach their flour with ozone or chlorine. The 
very white bread of to-day does not deserve the name of 
the staff of life, and it works great 
injury to public health. No wonder 
few people have sound teeth. Unless 
the children of our land are suitably 
fed, it is vain to hope that they will 
grow into staunch useful men and 
women. About two fifths of the weight 
of food consumed by most families con- 
sists of flour or bread. Hence good 
flour is an important step in the work 
of making the food of the people as Grain ot Wheat cut 

, , through (enlarged). The 

nutritious as possible. For Very innermost of the three outer 

-1 •, r\ i_ L ^o Ti-i. layers contains a valuable 

white flour about 68 per cent of the proteid called gluten 
grain is made use of ; the rest, with its 
phosphates and other food for the teeth, bones, and nerves, 
is rejected. In making the tasteless white flour, not only 
the brown, outer layers are thrown out, but the central 
germ also, which is rich in proteid and fat, has a delightful 
aroma, and gives good bread its " nutty " taste. 

Coarse foods are the most wholesome. The outrage 
worked by modern machinery (abetted by unthinking 
housekeepers) upon rice, is even greater than upon wheat. 
Unpolished rice is more nutritious than the tasteless white 
rice which has lost a valuable outer layer, and is often made 




io4 



THE PEOPLES HEALTH 



white and glistening with talcum powder. An ounce of 
unpolished rice contains 90 grains of proteid and 48 grains 
of valuable mineral more than is found in polished rice. 
Living on polished rice is believed to be one cause of the 
disease called beriberi, and it is said to have been cured by col- 
lecting the material ground off the outer coating cf polished 

rice and giving 
it as a remedy. 
Good rice has a 
dingy color. 

The best wheat 

flour is not dingy 

and dark, but 

creamy in color. 

Rats, mice, and 

pigeons fed on 

white bread and 

water cannot be 

kept alive; they 

live if some of 

the sharps and 

bran removed in milling, are replaced in the flour. Indian 

corn bread made of unbolted meal has a greater variety 

of elements needed by the body than starchy white meal. 

The efforts of factories to boost their goods by appealing 
to finicky purchasers, has injured the general health. 
Superfine salt lacks traces of elements found in fresh sea 
salt and believed to be necessary to a hale body. Golden 
sirup is usually cheap glucose. Dark molasses and sugar- 
house molasses, like brown sugar, owe their dark tint to 
iron, the same element which makes the blood red. Reliable 
sirup for the children may be made by boiling brown sugar 




Courtesy of New York City Dcpt. of Child Hygiene. 
Malnutrition Cases in New York City Schools. 



FOOD VALUES AND ECONOMY IN FOOD 105 

with water. Refined sugar is not as healthful as brown 
sugar, and the extensive use of it has enabled a few to con- 
trol prices. 

The more factory processes the people are persuaded 
are necessary for food products, the easier it is for merchants 
to keep the producer and consumer apart, control the 
trade, and raise prices. Sometimes the farmer is even 
persuaded to sell the foods he produces and buy them back 
slightly changed and put up in pretty boxes. Wheat or oats 
can be cooked all night in a fireless cooker and be ready 
for breakfast next morning ; they make fine breakfast foods 
at two cents a pound. They can be bought crushed, rolled, 
or puffed (and half cooked) in a beautiful carton at 30 
cents a pound. If unclean, they cannot be washed like the 
glossy whole grains. Such prepared breakfast food is 
staler and less palatable than if it came direct from the farm. 
In the procedure, many middlemen have been paid. A 
can of beans or peas costs 1 5 cents a pound ; a pound of 
lima beans costs 8 cents, and one pound of dried beans 
equals the beans in two cans ; how many times cheaper are 
dried beans than canned beans. A farmer can hardly 
imagine that he likes citified food better than fresh food. 

Sorghum sirup can be made in almost any farm neighbor- 
hood. Its sugar is cane sugar (sucrose), not glucose, and 
is much superior to " corn syrup." Dr. H. W. Wiley says : 
" Sorghum syrup has a peculiar flavor which is not dis- 
agreeable to those accustomed to its use. It is extremely 
wholesome, highly nutritious, and palatable." 

Boxes and cans and tight packages protect food from 
dust, but it may be weevily or wormy because insects' 
eggs were laid in it before it was packed. Breakfast 
cereals are sometimes sold in boxes upon which are printed 



106 THE PEOPLES HEALTH 

extravagant claims as to thoroughness of cooking and 
wonderful nutritive power. Even if the pound in the box 
or can is not one to three ounces short weight, the grain 
is not as nutritious as when it was fresh on the farm. 
Fancy foods are usually poor foods; they are less easily 
digested than plain foods, and there is more chance for hum- 
bug. Be shy of advertised foods, but do not stint on good 
wholesome food of the old-fashioned kind. 

There are quack foods as well as quack medicines. An 
example is " brain food "; there is no such thing as a 
brain food. Two cents' worth of vaseline is perfumed and 
dyed and sold for a dollar as skin food, " warranted to 
make old skins new, and dried-out skins fresh and rosy." 
The skin can breathe and perspire, but it cannot eat. You 
may hold your hand in milk for hours, but no milk will be 
absorbed by it. 

Our bodies inherit the wisdom of the ages. Here is an 
example of this wisdom : the body manufactures oil to 
keep the skin supple and the hair soft, yet by no process 
has man been able to make oil by machinery. Man's 
reason often interferes with natural instincts and priceless 
powers, simply to follow a fad started by some schemer to 
fatten his pocketbook and flatten those of others. Man's 
instinct will guide him to select the things needed among 
simple, natural foods ; instinct is hopelessly in the dark 
among the concentrated, spiced foods offered on so many 
tables. Nature gives danger signals to those who will 
heed them. The habit of overwork brings a persistent 
fatigue; too great mental excitement brings on sleeplessness ; 
excessive eating or the use of wrong foods is betrayed by 
fullness, gas, colicky pains, or by headaches. Eat simple 
food and trust to your instinct. " Worry about diet is 



FOOD VALUES AND ECONOMY IN FOOD 107 

the surest road to dyspepsia" (Dr. W. A. Evans). A 
sensible person can think about food without worrying 
about it. 

When you eat, how you eat, and how much you eat are 
more important than what you eat, provided the food is 
pure. Office workers often eat too much. Scant outdoor 
life and little use of the muscles call for moderation at 
the table. A man who eats 
three meals a day, nibbles 
at snacks between meals 
and takes a little bite, some- 
times a big one, before re- 
tiring, has no right to scorn 
those who drink alcohol. 

Workers in offices and at 
machines that furnish all 
the power must either limit 
the food eaten or increase 
tJie outdoor exercise taken. 
Either plan is good ; the 
second is better. Addison ™ ovn *\ PKJ TV" THE < St ° mach ' 

photographs with X-rays during ten 
Said: " Temperance in eat- seconds. The wave passes to the pylorus, 

or keeper of the gate. While one is teased, 
ing in many Cases produces worried, anxious or angry the waves stop. 

the same effects as exercise, {j™ inthe food made movements 
and may in some measure 

supply its place." Plato, a wise Greek, said : " The names 
given to diseases by doctors only serve to hide the fact that 
their patients have worked too little and eaten too much." 
The food tube is the canal along which we send the food 
in order that the cells in its walls may absorb what is 
needed. This canal, or tube, is a muscular organ which 
contracts in waves to mix the food and move it along. 




108 THE PEOPLES HEALTH 

If food is too concentrated and bland, with all fibrous 
parts removed, the tube has no resistance to contract 
against, and cannot move the soft pulpy food along. This 
smooth pulp lacks all stimulating power, and does not 
arouse the muscles in the walls of the tube to contract. The 
tube is a motor organ, but it becomes weak and torpid, 
the food stagnates and decays, and the body is polluted. 
The way to avoid this is to eat food more nearly in its 
natural condition, and avoid food with its texture ground 
out of it, the coarse part sifted out at the mills, and the 
life cooked out of it in the kitchen. 1 

1 Chewing and evacuating, the beginning and the end of digestion, are 
the only steps in it that are voluntary. Starchy food should be chewed 
long; the mill and the cooking stove should not make this impossible by 
doing all the work beforehand. Meat does not need long chewing. Milk 
and meat eaten together may cause clogging (constipation). Pasty, con- 
centrated food often causes this condition. Not only whole wheat bread, 
but bran bread, may be eaten. There should be about an ounce of woody 
fiber (cellulose) in the daily food of every one. This fiber is found in most 
leafy and root vegetables. Raw cabbage is a better laxative than agar 
(a seaweed) used as a laxative, but because cabbage, unlike agar, is not 
sold in drug stores, most people will not believe so. Another health super- 
stition is that onions must be very healthful, since they have such a bad 
odor. 

Fasting or liquid diet is constipating. Fasting interrupts the daily rhythm 
of the intestine. This daily rhythm causes the call of nature which should 
be treated with respect. By the cleanly and refined, it is not disobeyed for 
the sake of other duties, however pressing. The only cause of bad health 
in some persons is that they will not clean out and keep clean. Even a daily 
movement may not mean freedom from constipation ; for the lower bowel 
may expel part of its contents without becoming empty. This state is 
shown by the excreta being dry and hard from too long a stay in the intes- 
tine. For explanation of the call of nature, see "Hygienic Physiology," 
Fig. 125. Standing for a while after meals encourages the call of nature. 

Purgative drugs only serve to fix constipation as a habit. Vegetables 
and whole-grain foods, walking, horseback riding, exercises requiring trunk 
bending and deep breathing, and cold baths make drugs unnecessary. 

Self-poisoning may occur gradually from the products of putrefaction 
in the small and large intestine. Constipation makes people old before 
their time. Moderate eating is especially necessary as life advances. When 



FOOD VALUES AND ECONOMY IN FOOD 109 

The Teeth. — Since the first step in digestion takes place 
in the mouth, the teeth should be sound that the mouth 
may be clean. If not, the filthy, fetid-smelling substance 
given off by decaying teeth becomes mixed with the food 
and goes with it to the stomach. 

Americans have been called a race of food bolters. Those 
who live their lives in a hurry soon lose the art of dining. 
Of the thirty-two feet of alimentary canal, the owner can 
control the first three inches. But it is also important to 
control his hands ; for if they shovel 
in the food too fast, the mouth cannot 
keep up with its work. 

One who eats rapidly never knows 
how good things taste. We should 
chew, or rather munch, by the tasting 
method ; that is, we should think of 
the taste and not of the chewing. chew with y QU 5 teeth, y° u 

have no gizzard ! 

Not only is bulk and coarseness 
necessary in food, for the reason you have learned, but, 
likewise, hardness and toughness is needed, for the mouth is 
a grinding organ. Eat food that requires the teeth to be 
used. Remember that " there are thirty- two in the gang 
and you are the boss; make them work." If they do not 
work, they will decay. 

Eat foods (which kinds ?) that supply the minerals needed 
for making teeth. Toothbrushes and powders, though 
faithfully used, cannot make the teeth grow sound and 

Edison was asked the secret of his remarkable vitality, he said : "Moderate 
eating. Cut down your food gradually until you start to lose weight. 
Then increase it a little and thereafter keep the weight constant. The food 
you then take will all be used, and the clinkers of the body furnace will 
pass into the large intestine free of food value and cannot putrefy and poison 
you, since they furnish no food for bacteria. " 




no 



THE PEOPLE'S HEALTH 



strong, instead of soft or brittle, if there is lack of 
mineral salts in the food. Whole-grain bread, vegetables 
and fruit, well-chewed nuts, prevent soft and decaying 
teeth. 

The teeth and mouth should be kept clean. Flushing the 
mouth with warm water after a meal removes particles of 
food. Most toothbrushes are too large. They should not 
be stiff enough nor used vigorously enough to make the 




Loaned by Dr. Herbert A. Pullen. 
Showing teeth before and after straightening. Crooked teeth are caused by 
adenoids, thumb sucking, use of a pacifier. 



gums sore. The teeth should be brushed up and down 
(from the gums) as well as from side to side. Brush their 
inner surfaces, the mouth being open; also the grinding 
surfaces of the back teeth. If the tongue is coated, it 
may be protruded and brushed. If a thread drawn between 
two teeth becomes frayed, this may have been caused by a 
cavity that is forming. 

Four things help bacteria to grow : warmth, darkness, 
dampness, and food. They find all four conditions in 
food left lodged between the teeth. Starch and sugar 
clinging to the teeth may ferment and form an acid which 



FOOD VALUES AXD ECONOMY IX F&OD 



III 



attacks the enamel. Go to the dentist before cavities 
have had time to become so large that teeth cannot be 
saved. One tooth lost throws several teeth out of work. 
Good teeth are the greatest aid to good digestion. 

Besides the high motive of health there are two lower 
motives for not neglecting the teeth. First, missing teeth 
or rotten teeth spoil the looks; no one can be handsome 
with ugly teeth. Would a boy or a girl with white per- 
fect teeth or one with rotten teeth find a job or position 




Courtesy of Dr. Herbert A. Pulltn. 
Portrait of a girl before and after her teeth were straightened. 



more quickly when starting out in life and looking for work ? 
Second, it is costly to neglect the teeth. A toothbrush and a 
little labor costs less than dentist's work. But go to a dentist 
when your mouth needs attention. A small dental bill 
may save a large dental bill and may possibly save a 
doctor's bill as well as lengthen the life. 

At two years a child should have as many teeth as it has 
ringers and toes. This completes the first set. The sixth 
year molar (the first permanent tooth) is the sixth tooth 
from the middle fine above and below. Watch it. It 



112 



THE PEOPLE'S HEALTH 



should be promptly filled if it shows a spot of decay, for 
no tooth will come in its place. 

A child should eat hard crust and foods that give work 
to the teeth, for the baby teeth should stay in until the 
teeth of the second set appear and actually push them 
out. If the baby teeth do not hold the places for the per- 
manent teeth to grow in, the jaw will not grow large enough 
The teeth will be crowded for room and cannot grow in a 
smooth line. See the pictures. It will not help the looks 
much for a girl to grow up with a pretty little pointed chin 
if it makes the teeth set zigzag in 
the jaw with some of them pointed 
outward like tusks. A broader chin 
with a dimple in it would look 
better, besides giving room for the 
teeth. 

Good toothpicks can be made of 
quills. Wooden toothpicks should 
be made of hickory or other wood 
that will not splinter and lodge in 
the mouth, perhaps causing an ab- 
scess. Prepared (precipitated) chalk bought at the drug- 
gist's, either alone or mixed with one fifth its weight of pul- 
verized Castile soap, makes as good a tooth powder as fancy 
powders sold at a high price. To use, turn a tablespoonful 
of it into a hand or saucer, and touch with the wet brush. 

If the gums are weak, a particle of grit or a deposit of 
lime called tartar may raise the gum from a tooth and cause 
inflammation. Sometimes in the effort of the cells to re- 
move the intruding particle, pus may be formed. The 
dentist can cure these troubles if consulted in time. Other- 
wise the tooth may become loosened. 




Rub the inner surfaces. 



FOOD VALUES AND ECONOMY IN FOOD 



1J 3 



Bad teeth interfere not only with efficient citizenship, 
but they may prevent a man from serving as a soldier at 
all. If soldiers cannot eat and digest well, they cannot 
make long marches. The teeth of recruits are examined 
carefully. Good general health and good blood usually 
mean good teeth. 

Test Questions. — What is the relation between defective children 
and food ? Into what three classes are foods divided ? Name sev- 
eral of each class. What is the unit of value of foods ? About how 
many calories should a day's ration contain? Name foods of high 
fuel value. Name foods which supply few calories per pound. Why 
are the several kinds of food necessary? How may a fat person 
reduce weight ? 

Compare the food values of beef and peanuts ; beef and cheese. 
Name foods which supply much nourishment for little money. What 
food in the table given makes least return for ten cents? Compare 
two lunches. What is meant by a balanced diet ? Give an example. 
Describe a too stimulating diet. What is the diet of the Arab? 
Japanese ? Chinese ? 

What were probably food customs in the stone age ? What dis- 
advantage in cooking at a high temperature? What custom is fol- 
lowed by poor cooks? What foods did the Greeks eat? What is 
said of white bread? Of the best kind of flour? Of coarse foods? 
Salt? Sirups? Sugars? Breakfast foods? Quack foods? Man's 
instincts? Exercise and food? Repeat the quotation from Addison ; 
from Plato. 

What is the nature of the food tube? Why is coarse food better 
than bland food ? Have you read the footnote on the clogging of the 
intestine? What evils follow decayed teeth? Why should we eat 
slowly? What kind of food makes sound teeth? How should the 
teeth be brushed? What conditions help bacterial growth? What 
are the advantages of sound teeth? What is best for toothpicks? 
What causes teeth to become loose? How may bad teeth affect 
citizenship ? 

Thought Questions on Previous Chapters. — Why is it to 
your interest and happiness that tuberculosis patients be cured ? Is 
an epidemic usually due to the misdoing of many or a few persons ? 
Which do you prefer, Dr. Pound of Cure or Dr. Ounce of Preven- 
tion ? Do you do your part to keep washroom, schoolroom, and home 



114 THE PEOPLE'S HEALTH 

clean and in good order ? Is it the duty of the state to aid us in pro- 
tecting against fire in schoolhouses ? To aid us in protecting pupils 
against infection ? What shall we do to keep the chief gateways for 
germs closed against them ? They are as follows : . breaks in the skin, 
sore gums, gums loose from the teeth (improper use of toothbrush), 
unsound tonsils, adenoids, unsound mucous membrane of nose, air 
passages, lungs. Why should we not sit too close to snimers 01 
coughers ? 

It costs about 2 cents more per quart to produce clean milk; is it 
worth it ? Does the government stamp on a piece of meat prove that 
it is safe? Discuss these sayings: "An apple each day keeps the 
doctor away." " A tooth in the jaw is worth two on a plate." Brit- 
ish workmen eat chiefly white bread, tea, and jam ; suggest better food 
at less cost. Bacteria grow upon undigested food long delayed in the 
food tube and form toxins ; signs of toxins are headaches, sallowness, 
sleepiness, nervousness, bad breath, bad taste in the mouth. Is it 
better to prevent this by decreasing the food or increasing the exer- 
cise ? The body needs a good shaking up each day : does yours get 
it ? A" bilious attack " is an effort of the body to rid itself of toxins ; 
how may we avoid such attacks ? Why are the lungs, liver, kidneys, 
and the blood itself better blood purifiers than any drug ? 



CHAPTER VII 



THE PREVENTION OF INFECTION: HUMAN CARRIERS 



Diseases are not blown long distances through the air, 
but are carried by (i) insects, (2) higher animals, (3) most 
of all by human beings, and (4) by their discharges. These 
discharges may be scales from the skin, secretion from the 
nose, or excretion from the intestine. That which man has 
contaminated is that which contaminates man. 

The moist breath of a patient should not be taken into 
another's lungs. It has been proven in several cases 
(scarlatina, tuberculosis) that germs adhere to floating par- 
ticles of dust. Air that is free from 
dust is usually free from germs. 

Perhaps more deadly disease has 
been carried by kissing than in any 
other way. If the kissing of help- 
less babies is stopped, thousands 
of lives will be saved. 

About 2 per cent of typhoid fever 
patients continue to be carriers for 
at least a year after having the 
disease. Smallpox is spread mostly by mild walking cases 
that do not take to their beds. It hardly goes through 
the air at all. The bacilli of pneumonia and diphtheria 
are found in the mouths and noses of many healthy people. 
They may be of harmless strains or races, but a sojourn 
in some particularly vile human body may render them 
poisonous. Known bacilli carriers should not be allowed 
to handle food products. The roadbed of railways is 
often polluted by train toilets. Campers (in construction 

"5 




Sneezing or coughing is a source 
of danger. 



u6 



THE PEOPLES HEALTH 



camps, etc.) may pollute the soil and affect the health of 
the whole community. Contractors and others should be 

required by law to burn 
every bit of refuse about 
camps. 

It is a relief to nervous 
people to know that the 
doctrine that disease germs 
are everywhere has been 
exploded. We now know 
that disease germs have 
their homes in the bodies of 
living hosts. The dread of 
disease germs everywhere, 
— books and brooks and 
everywhere in earth and 
air, — need disturb them 
no longer. Living beings 
are the true reservoirs 
of disease. The role of 
human beings in carrying 
typhoid and tubercle bacilli has already been described. 
Some infectious diseases are hardly more than contagious; 
that is, they are spread by contact. 
Germs are most dangerous when 
fresh. They are more likely to infect 
when they come right from a dis- 
eased person or something that he 

has recently touched. Why should we never use a 

mi i r i j • • public hairbrush or comb ? 

The many wonderful discoveries 
concerning the way infection is carried have led people to 
think that the ways of infection have all been explained. 




Have a Bite ! (Polite but unclean.) 




PREVEXTIOX OF INFECTION: HI/MAN CARRIERS 117 

This is an error. There are many problems yet to be 
solved, some of which will be mentioned in this chapter. 

Diphtheria. — The diphtheria germ which grows in the 
throat was one of the first disease germs to be discovered. 
This disease is most likely to occur in childhood. It may 
be merely a sore throat, or it may become a very serious 
disease. 

A few hours after the sore throat is complained of, fever 
may be noticed. In membranous croup, which is a severe 
type of this disease, a hoarse cough or difficulty in breath- 
ing is followed by the growth of a membrane in the wind- 
pipe. In most cases, after the fever makes its appearance, 
the child becomes drowsy because of a toxin formed by 
the germs. 

Diphtheria is now treated with an antitoxin (meaning 
" against poison ") formed in this way : Diphtheria toxin 
is injected into the blood of a horse in repeated doses. 
The horse has the disease in so mild a form that it is 
hardly noticeable, and the horse's blood works up a large 
amount of antitoxin to destroy the toxin. Some of the 
horse's blood is drawn from a vein and allowed to clot ; 
the serum, or watery part which separates out, contains 
the antitoxin. 

Some of this serum is injected beneath the skin of a 
patient with a tiny, hollow needle. The antitoxin does not 
kill the germs, but destroys the toxins they have formed. 
Thus the body is kept from being poisoned until it can 
kill the germs or stop their multiplication. If this is done 
the first day of the disease, it i c almost certain that the 
patient will get well. Before antitoxin was used, about 
half the cases of diphtheria were fatal. If the antitoxin is 
not used until the second dav, 95 cases out of 100 will re- 



n8 



THE PEOPLES HEALTH 



cover; used on the third day, 90 cases out of 100 will 
recover. 

If any others have been exposed to the disease, they should 
be given the antitoxin at once. If they then have the 
disease at all, it will 
probably be a very 
slight attack, for the 
antitoxin is there 
ready to destroy the 
toxin. They should 
be kept at home. 
One person who has 
become infected with 
diphtheria is infectious 
to others from the day 
he was exposed to it. 

Treatment with an- 
titoxin blood serum 
is not exactly the 
same process as vac- 
cination, for no germs 
are injected in the 
serum. 

Many diphtheria patients carry virulent germs in the 
throat for a year or more after they are well. These 
diphtheria carriers cannot be kept in quarantine, and what 
to do with them is a problem. They should be careful 
not to use a public drinking cup, and we should not 
drink from cups which such carriers may have used. Pet 
cats have been known in some cases to spread diph- 
theria. 

The mother wonders why her child has diphtheria, yet 




By courtesy of the 
How Disease is Spread, I. 



PREVEXTIOX OF INFECTION: HUMAN CARRIERS 



119 



she knows that a neighbor's child with a sore throat has played 
with her children. If a child suffers with a cold and stiffness 
of the neck, examine its throat. Of course a person with a 
sore throat should never kiss any one. A baby should be 

kissed on the cheek, 
if at all. 

Pneumonia . — The 
dry air of overheated 
houses is a predis- 
posing cause of 
diphtheria and pneu- 
monia. 

Pneumonia goes 
hardest with those 
who have been habit- 
ual users of beer, 
wine, or whisky. 
The idle, the fat, the 
sluggish are predis- 
posed to it. Most 
people have pneu- 
monia germs in their 
air passages, but suf- 
fer no harm, for the body resists them well. Weakened 
by strain or excess, a person may catch pneumonia from 
himself. This may happen when the bodily resistance is 
lowered by sleeping in an unventilated room, by typhoid, 
measles, drunkenness, unusual exposure, or a severe cold. 
The germs in the body of a pneumonia patient are more 
poisonous than those found in people who are not sick. 
One who has been ill with it probably harbors a more 
dangerous strain, or race, of the germs (the pneumococcus). 




American Museum of XcUural History. 

How Disease is Spread, II. 



120 



THE PEOPLE'S HEALTH 



Since it is slightly contagious, do not remain close to 
people in public places who are coughing, sneezing, or 
spitting. A big dose of new and perhaps worse germs, 
added to those you already have in your throat, may 
prove too much for the defending cells. 




From " The Bitter Cry of the Children." 
A Consumptive Mother working on clothing for the general market. We can- 
not protect the health of one unless we protect the health of all. 

Colds prepare for the development of pneumonia. To 
avoid cclds, breathe plenty of fresh air and keep away from 
dusty air and the dried-out air of overheated houses; 
take cold baths, sleep in cold rooms ; keep the purifying 
organs (skin, lungs, liver, kidneys, and bowel) in working 
order. Cold weather causes pneumonia by causing closed 



PREVENTION OF INFECTION: HUMAN CARRIERS 121 

doors and windows. The poor live in crowded rooms or 
hovels, the rich have roomy, hygienic homes, but often 
fail to live hygienically. 

Grip or Influenza. — The germs of grip live in the mouth. 
throat, and windpipe. They sometimes remain for a year 
after recovery from the disease. These germs are also 
found in the spittle and in the discharge from the nose. 
but they are quickly 
killed bv drvins:. and do 



not multiply outside the 
human bodv. 



CL^N?^|^r0^oRlZED 



The bacillus of grip This label on clothing shoW5 that it was not 

forms a DOWerful toxin ma de under conditions that spread disease and 

the worker was paid a living wage. 

that affects the whole 

body. The poison is not so dangerous as that from the 
diphtheria germ, but it leaves the body ^eak. This weak- 
ness may linger for months and render the body an easy 
prey to pneumonia, consumption, or other dangerous dis- 
ease. Hence the after efects are more dangerous than the 
disease itself. 

An attack of grip does not make one immune to a second 
attack. Do not touch the hands, dishes, nor handkerchief 
of an influenza patient until they have been disinfected. 
Grip is avoided in the same way that colds are prevented. 
It come: on suddenly; a cold sometimes gives warning. 
Grip is usually accompanied by chill and fever, prostra- 
tion, headache, backache, pain in the legs, yellowish and 
lumpy spittle. The sufferer should keep in bed. take no 
solid food, drink plenty of water and lemonade, have hot 
foot baths or sweating baths. All discharges from the 
nose, throat, and lungs should be disinfected. 

Colds are probably caused by various germs. The germs 



122 



THE PEOPLES HEALTH 



which at one time cause pneumonia or grip, may at other 
times cause the inflamed mucous membrane called a cold. 
A man may catch a cold from himself when his resistance 
to germs is lowered. Colds in winter are often caused by 
impure house air, or by overheated houses. Colds in 
summer may be caused by chilling the skin at night, es- 
pecially when it is moist with perspiration. It is well to eat 
nothing but fruit during the first stages of a cold. Sleep- 




• Va. Health Bulletin. 

Loathsome and dangerous diseases may be spread by the use of a public drinking 
cup. The delicate, well-dressed manor woman is more likely to be infectious than 
the vigorous day laborer. 

ing on a porch prevents colds. Cold is the surest prevent- 
ive of colds. Cleanliness is also a preventive. The habit 
of putting the hand often to the mouth, nose, or eyes, is 
uncleanly ; for the hands may have touched unclean things 
— perhaps the hand of a person with a cold, a door knob, 
a toy, or utensil which he has handled. What habits 
of living have you already learned protect us from colds ? 
Scarlet Fever, Measles, Whooping Cough. — These are 
partly air-borne diseases and are hard to control, for we 
cannot disinfect the air. The droplets of saliva that fly 
out of the mouth while one coughs or speaks may spread 



PREVEXTIOX OF INFECTION: HUMAN CARRIERS 123 

these diseases. Sneezing probably spreads the measles 
more frequently than the scales from the skin spread it. 
The eruption of both measles and scarlet fever may be 
looked for in the mouth before it shows on the skin. 

Scarlet fever, sometimes called scarlatina, most often 
attacks children under ten years of age. The eruption on 
the skin usually begins at the neck and appears on the first 
or second day after the* first symptoms (fever and sore 
throat). 

Scarlet fever germs may live for a long time on clothing 
or material not exposed to sunlight. Scales from the skin 
and all secretions and discharges of the patient are in- 
fectious, and if not properly disposed of, may be carried in 
dust and infect others. The disease is often spread by 
" walking cases " so mild that they are not recognized. 
The after effects of scarlet fever upon the ears or kidneys may 
be bad. Before the body has recovered its strength, 
pus-forming bacteria may attack the ears and cause partial 
or complete deafness. The germ of scarlet fever has not 
been discovered. Some think it is akin to the pus-forming 
bacteria. 

After a case of measles the eyes must have rest and care, 
or they may be weakened for life. Measles is a more serious 
disease than it is generally supposed to be. They make a 
mistake who do nothing to prevent catching the measles. 
Quarantine and disinfection should be strictly enforced. 
A patient is infectious as long as there is a discharge from 
the nose or eyes. This continues usually for about three 
weeks after the breaking out of the rash. 

Whooping cough causes more deaths than scarlet fever 
and smallpox combined. Its victims are usually infants, 
and it is not greatly dangerous to children over two years 



124 THE PEOPLE'S HEALTH 

of age. The older a child is, the better he resists the disease. 
Grownups usually have very mild cases, if they take it at all. 
Very young children should be carefully protected from it. 
Contagion is greatest before the whoop begins; there is 
not much danger after it has run three weeks. It has 
been proposed that children with the whooping cough even 
in its later stages wear a band of green ribbon on the arm as 
a warning of danger to other children. 

Granular lids (trachoma) is a disease of the eyelids that 
is easily prevented by cleanliness. It is spread by the 
roller towel and using a borrowed pencil 
or other article and then putting the 
hand to the eyes. The disease is rife 
among the Indians, and was spread among 
them chiefly by their schools. Whole 
tribes are now threatened with blindness. 
If untreated, granular lids cause per- 
manent injury to the eyesight in three- 
fourths of the cases. 

Paper Towels. Do 

not use a public towel. The danger from human . carriers of 

A virus carrier may have , , , . , , ■, •!_ j • 

just used it. The skin tuberculosis has been described in an 
will dry in one minute. ear ii er chapter. What did you learn 
concerning the habits of careful consumptives and of heed- 
less ones? Not many tubercle bacilli are found in city 
streets, because drying and sunlight kill them. They live 
longer on the rim of a drinking cup or in a closed, unused 
room. A consumptive should sleep alone and, if possible, 
in a separate room. Not only he, but every one else, should 
pass a part of every day out of doors ; for man is an outdoor 
animal, although he no longer trains his muscles, steadies 
his nerve, and expands his lungs in hunting and the chase. 
Although we should avoid heedless people who carelessly 




PREVENTION OF IXFECTION: HUMAN CARRIERS 125 

pass disease germs on, we should not forget that most 
germs are harmless. Sometimes 50 different species of 
germs are found in the food canal ; they are legion in num- 
ber and most of them are harmless. Many kinds are found 
on the skin and cannot be washed off with soap and water. 
A sound skin built out of healthy blood is a better safeguard 
than soap. We bathe as much to keep the skin vigorous 
as to keep it clean, for the reasons given in the " Hygienic 
Physiology," pages 27-30. 

Disease germs are usually harmless to robust people. The 
mistletoe does not kill all the trees it grows on. Many 
vigorous trees are able to hold its growth in check on them- 
selves, and bear it unharmed; thus they keep up a source 
of infection for neighboring trees. Rugged health is the 
best protection against the enemies of the body, each of 
which, after all, is only trying to live its life in its own way. 
These hurtful parasites would perhaps never have formed 
the habit of living in the human body if material for them 
to live on had not been allowed to accumulate by those who 
led unsound lives. 

Let us recall the methods of the body in defending itself 
against germs. If the ringer is pricked with a needle, and a 
drop of blood is drawn and examined with a microscope, 
its red and white cells are seen floating in a colorless liquid. 
One drop contains millions of red and many thousands of 
white cells. If a colony of germs is conveyed to the drop 
of blood, the white cells will flow about the germs and engulf 
them. The germs can still be seen in the white cells, or 
devourer cells, until they are gradually digested. There 
are 50 billion white cells, or devourer cells, in the body — a 
great standing army. They may multiply so rapidly that 
one cell may become a grandparent within an hour. If the 



126 THE PEOPLE'S HEALTH 

white cells have been weakened by ill health, or the bacteria 
are very poisonous, the bacteria may destroy the white 
cells instead of being digested by them. The healthy body 
can whet the appetite of the devour er cells by forming certain 
substances (opsonins) which serve as sauces to the bacteria 
and cause white cells to eat them greedily. 

Disease germs do most harm by throwing of poisons, or 
toxins, which injure the tiny, invisible citizens, or cells, 
that compose our bodies. When disease germs gain 
entrance to the body, you have learned that there is a 
new activity in the cells and tissues. As a result of this, 
new substances called antitoxins or antibodies are secreted 
into the blood. - These antibodies have the power of 
combating the poison formed by that particular kind of 
germ. Since more antitoxin than is needed is usually 
secreted, the body is protected from further attacks of the 
disease. Scientists have learned that it is well in some 
diseases to kill germs by heating them, and inject them 
under the skin through a hollow needle, to stimulate the 
forming of antibodies. Being dead, they cannot increase 
in numbers, and the devourer cells soon eat them. It is 
believed that the antibodies not only make harmless the 
poisons, which the live disease germs form, but they may 
also kill the disease germs, or weaken them and prevent 
their multiplying. 

Meningitis is an inflammation in the membranes around 
the brain and spinal cord. Several kinds of germs may 
cause it. The pneumococcus of pneumonia, it is believed, 
sometimes causes it. There are also cases of tubercular 
meningitis. Influenza and typhoid germs may cause it. 

One-third of the cases are caused by a special germ that 
causes no other disease. This kind of meningitis is in- 



PREVENTION OF INFECTION: HUMAN CARRIERS 127 

fectious. The germs are found in the nose of the patient. 
It dies quickly on drying, but it may be spread by the 
means of drinking cups, handkerchiefs, the hands, or drop- 
lets sent out while coughing or sneezing. The discharges 
from the nose of a patient should be carefully destroyed. 
Human carriers play a very important part in spreading 
this disease. Of twenty people who are infected with the 
germ, perhaps only one will have the disease, while the 
others continue to carry the germ and spread the infection. 
In the first chapter you studied about the prevention of 
smallpox. Once a great scourge, vaccination has almost 
done away with it in communities that are careful. Where 
vaccination is neglected, it usually increases again. Clean- 
liness and a healthy body also help to ward it off. Vacci- 
nation protects for several years, in some cases perhaps, 
for ten or twenty years. If smallpox appears in the 
neighborhood, those who have not been vaccinated for a 
year should be revaccinated. Those who have already 
been exposed should be promptly vaccinated, as the vac- 
cination may take effect before the disease can develop 
and make the case milder. 




Jl 



The tetanus germ cannot multiply unless it is shut away from oxygen of the air. 
This hurt was made by a nail. Never pass a nail point protruding from a plank 
until you have bent it down. 

Tetanus or Lockjaw. — The germ of this disease is one 
of the few disease germs that form spores. Its home is in 
the soil. It is harmless to • cattle and horses, is often 
swallowed by them, and passes with their droppings into 



128 



THE PEOPLE'S HEALTH 



the ground of stables and streets. It cannot be trans- 
mitted by human carriers. 

It sometimes gets into wounds. A boy's foot may be 
injured by a rusty nail upon which is a tetanus germ and 
the germ may be left in the wound. If it is the only germ 




By Courtesy of Columbus N. Millard. 
Independence Day. This way of celebrating the national holiday results in many 
wounds, cases of lockjaw, and deaths. 



present it will not grow unless the air is shut off from it. 
It grows best in deep wounds or jagged wounds which close 
over. 

Since the germ's home is in the earth, wounds on the 
bare feet of children should be carefully disinfected and 
protected from dirt. Turpentine or peroxide of hydrogen 
may be used for this. Washing a wound with too strong 
a disinfectant, or with too much of it, may injure the cells, 



PREVENTION OF INFECTION: HUMAN CARRIERS 



129 



weaken their resistance to germs and their power to repair 
the wound. 

The tetanus germ makes a poison which is stronger than 
strychnine. The first symptoms of the disease are stiff- 
ness of the muscles of the jaw and neck. An antitoxin 



aMtSS^wJU&itf . ^ a. A\ 


WT 


g> 1 


■ Sift* y ! 


1 ; 


5 ? 






|PP 



A Safe and Sane Fourth. Here are some country boys starting in a race at 
an athletic festival. They also had hurdle, sack, relay races, three-legged, potato, 
leap-frog race and hoop race, broad, long, and high jump, and other events. 

has been prepared but it must be used in a very early 
stage of the disease. 



Test Questions. — What used to be taught concerning infection 
through the air? What are the four most common sources of infec- 
tion? How are disease germs carried in the air? What is said of 
kissing? How is smallpox spread? W r hat is said of campers? 
What is the natural home of disease germs? 

Where does the diphtheria germ live? How is diphtheria treated? 



13° 



THE PEOPLE'S HEALTH 



With what success? How is the antitoxin prepared? What is to 
be done when others are known to have been exposed to diphtheria ? 
Are there diphtheria carriers ? Who have pneumonia most severely ? 
What is meant by a person catching pneumonia from himself ? What 
is known of the germ of grip ? In grip, what is it 
that does the harm ? What is said of its after effects ? 
How does grip differ from a cold? How is catching 
a cold from others avoided? 

Name three air-borne diseases? Where does the 
eruption of scarlet fever first begin? What organs 
are most liable to injury after scarlet fever? After 
measles? At what age is whooping cough a most 
dangerous disease ? Why should it be shunned ? 
How are granular eyelids most often caught? 
Notice the Xell of this disease among the Indians. How may 
of Several bacilli danger fr° m a consumptive be avoided? What is 
said of mistletoe? Describe the activities of white 
blood cells. What are opsonins? Antibodies? What have you 
learned of the lockjaw germ and of lockjaw? Why are human 
carriers so important in meningitis ? What precautions are necessary ? 




Tetanus Bacil- 
lus. 




Tag used on tag day at Oroville, 
Calif., to raise money for war on 
mosquitoes. Chills and fever de- 
creased one half the first year. 




Mosquitoes breed in tubs and tin cans. Invert tubs, 
cut holes in cans. The malarial mosquito only moves 
200 yards from breeding place. It flies at dusk. It 
does not fly about, but goes straight to victim. 




Courtesy of Col. Geo. W. Goethals. 
Applying Crude Oil to water in a ditch by use of knapsack sprayer, Mirafiores 
C. L. Oil is also used for treating grass before burning. Vegetation so treated and 
burnt is very slow in growing again, thus leaving the ditches clear. 




Courtesy of Col. Geo. W. Goethals. 
Sanitary Drip Barrel at Panama. It drips mosquito oil automatically. 



CULEX 



ANOPHELES 




Culex 

Anopheles (malarial) 

Courtesy of Dr. L. O. Howard, U. S. Bureau of Entomology. 

Development of common mosquito (Culex) at left and malarial mosquito 

(Anopheles) at right. How are the eggs of each kind grouped ? The wiggler of which 

kind lies close to surface of water? What is the resting posture of each mosquito? 

Which kind has five long parts on head ? Which is more uniform in tint ? 

The eggs of the two species are differently shaped. Which larva (or wiggler) 
has the longer breathing tube ? Which pupa (or bullhead) has the larger head ? 



CHAPTER VIII 

THE PREVENTION OF INFECTION : INSECT CARRIERS 

Experiment i. To watch Flies hatch. — Put half a spadeful of 
rotting horse manure containing the shiny brown pupa of the house fly 
in a glass jar. Tie a thin cloth over the top of the jar and observe it 
for a week. (Flies do not breed in manure which has become thor- 
oughly composted or which has not yet begun to ferment.) 

Experiment 2. To study Development of House Fly. — Place in a 
glass jar manure containing eggs of house fly, or cheese or meat upon 
which eggs have been laid by blow flies, and record date. At intervals 
of three days, remove some of the material and sketch larva (maggot) 
or pupa found. If flies and manure containing no eggs are placed in 
a jar, date recorded, and flies killed after eggs are laid, and a cloth tied 
over the jar, the time of development for the house fly can be found. 

Experiment 3. To find whether Flies can hatch in Garden from 
Manure plowed under. — Obtain a quantity of house-fly pupa and 
bury in 12-, 18-, and 36-inch deep wooden tubes filled with soil, closed 
at bottom, and covered with net at top. Do flies appear at top ? 

Experiment 4. Home-made Fly-swatter. — All members of the 
class may construct as good fly-swatters as they can. Test by use, 
and the class may decide which 
is: (1) most effective, (2) most 
durable, (3) the easiest made, 
yet efficient. As in other experi- 
ments the teacher will doubtless 

,. , . A Fly Swatter, made by sawing a slit in a 

credit scholarship grade of those wooden handle to receive a bit of screen . 

who excel in this work. 

Experiment 5. Sanitary Fly Survey. — Examine damp rotting 
papers and trash : wash out samples from manure, garbage, and trash 
heaps to separate larva and pupa of fly. Draw a map showing all 
breeding-places and unscreened outdoor closets found. Put a colored 
mark by all sources rendered harmless as result of survey. 

Experiment 6. To test Fly Traps, etc. — By counting flies caught 
in a certain length of time, test value of fly traps and sticky papers, 

i33 




J 34 



THE PEOPLES HEALTH 




iof»e. 



One of the notes made in sanitary- 
study of a home. 



and report. Make the tests side by side at garbage can, or else- 
where. 

Experiment 7. The Effectiveness of Screens. — Examine every 
screen door and window at home. What percentage of them have 
cracks or holes large enough to admit flies ? Why is there a passage- 
way open for insects if window is raised only part of the way ? 

Experiment 8. To breed Mosquitoes. — Obtain mosquito eggs 
by leaving a wooden pail filled with water overnight in the back yard. 

After they hatch, place them in water 
in a glass jar. Study their hatching 
and later stages ; manner of breathing, 
swimming, molting, with the changes 
to the wiggler, bullhead, and mosquito. 
(Tie net over mouth of jar before mos- 
quitoes hatch.) 

Experiment 9. Effect of Oil on Wig- 
glers. — Place wigglers in jar of water ; 
watch them breathe. Pour in several 
drops of oil. How long until they cease to breathe ? 

Experiment 10. To learn the Several Kinds of Mosquitoes. — 
Collect eggs, wigglers, and mosquitoes from as many different sources 
as possible. Compare them with each other and with the figures in 
this book. Learn the difference in eggs, larva, and adult of the " rain- 
barrel " mosquito (Culex pipiens) of 
uniform color, the " spotted- winged " 
(Anopheles), or malarial, mosquito, the 
" striped-legged " (Culex sollicitans), or 
salt-mp/rsh mosquito, and the " striped- 
bodied " (Stegomy'ia ; its name is to 
be Aedes calopus) or yellow fever mos- 
quito. Study the differences in position 
of eggs, larva, and adult. (See figs.) 

Experiment 11. Do Mosquitoes breed 
in Moist Soil or on Damp Plants ? — 

Look for eggs and wigglers under these conditions. Place suspected 
soils and plants in pure water and try to find wigglers. 

Experiment 12. A Mosquito Sanitary Survey. — Procure white 
enamel spoons and tin pails, divide the territory, assign pupils to 
work in couples. Map all breeding place discovered. Do not omit 
examination of : old tin cans (cut holes) , bottles, jugs, and jars (break 
them), that may have been scattered or dumped in your territory; 




Prevent Breeding of Mos- 
quitoes by screens on rain barrel, 
cistern, and shallow well. 



PREVENTION OF INFECTION: INSECT CARRIERS 135 




Courtesy of Dr. L. O. Howard. 
A Sanitary Survey. Examining pools for mosquito larva. 

rot-holes in trees, stumps, and logs (chop them out) ; track-puddles in 
road (fill them) ; plants (Spanish dagger, yucca) that hold water at 
foot of leaf stalk ; rain barrels, cisterns, house gutters that sag or are 
dammed up with leaves; ponds and small lakes; sewer traps and 
sewers. 

Experiment 13. The Enemies of Mosquitoes. — Test several 
kinds of fishes by placing them in a small aquarium or a large glass 



m^^^m^^^^m 








""'• j£ ' 


> : ^ .^. . * "- . , 


- ~r-- 



Courtesy of Prof . C. F. Hodge. 
Studying the breeding places of mosquitoes. 



136 THE PEOPLE'S HEALTH 

jar with wigglers. Test also the water boatman (notonecta), water 
spiders, water tiger. (Bats, dragon flies, and birds catch mosquitoes 
only while flying.) 

Experiment 14. To stop the Breeding of Flies. — A teaspoonful 
of Paris Green (poison!) is stirred into a common garden watering 
pot of water. This sprinkled upon manure will kill all maggots in it 
and improve it as a fertilizer. Sprinkle in box of outdoor closet. 

Experiment 15. To make Sticky Fly Paper. — Boil one pint of 
castor oil with two pounds of resin. Spread it on newspapers with 
an old paint brush. 

Experiment 16. To make a Fly Trap for the Garbage Can. — Cut 
a round disc of wood 6 in. in diameter, bore a hole in the center for 
the flies. Fasten upon the disc a cone made of wire net. Lay two 
sticks across the top of the can, lay a barrel top upon the sticks and 
set the trap over a hole made in the center of this top. (See page 147.) 

There are several kinds of disease germs that cannot be 
conveyed from person to person or carried in food or water. 

These are not bacteria. They 
are animal germs, and depend 
upon insects or other animals 
to carry them. 

Malaria is the commonest 
disease carried by insects. It 
has been proved that the mos- 
quito is its carrier, so that we 

Flies and mosquitoes are so great a 
torment to man and beast that they nOW Can Say, No mosquitoes, 
should be destroyed even it they were nQ malaria The bite of a 
not the greatest danger to health. 

spotted-winged mosquito that 
happens to have been infected with the malarial germ is 
more dangerous than the bite of a dog. 

A Ruined Countryside and the Cause. — The country 
doctor drew up his horse and stopped on the crest of the 
hill. " Yes," he said sadly, " this is the place. It used to 
be the prettiest part of the country, rich, fertile, and in- 
habited by the best people you ever saw in your life. But 




PREVENTION OF INFECTION: INSECT CARRIERS 137 

they built a dam down the creek and neglected to drain 
the country above. Pretty soon mosquitoes began to 
flourish and with mosquitoes came malaria. The result 
is that practically every family in the community is ruined. 
They have chills and fever, they cannot work, they are 





n 




^s 


, '"".3 ,^J 


1 



Courtesy of ('apt. Phillips, Sewer Dept., Washington, D.C. 
Oiling a sewer trap, Washington, D.C. (garbage disposal plant is seen in the rear). 
By draining the Potomac marshes near the city, and by attention to drains and 
sewers, Washington has been made free of malaria. 



hopeless. Yet, if the stagnant water here could be cleared 
up, the low grounds ditched, and the creek confined to its 
banks, the malaria would disappear. Isn't it wonderful 
what a little ditch kept clean will do to prevent malaria? " 
(Virginia Health Bulletin.) 

The first person to suspect that mosquitoes could carry 
disease, was Dr. Nott of Mobile, Alabama, who published 
a work in 1848, in which he upheld the mosquito origin 
of yellow fever. A New Orleans physician, in 1853, claimed 



138 



THE PEOPLES HEALTH 



the mosquito obtained the poison from decaying matter. 
Dr. Laveran of France found the malarial parasite in the 
blood in 1880. After nearly twenty years' search to find 
how this germ got into the blood, the truth was discovered 
by Dr. Ross of England, while in India. He proved that 

it was brought by a 
mosquito that had 
sucked the blood of a 
malarial sufferer. 

This tiny animal 
germ (plasmodium) 
burrows into the red 
cells; there it sub- 
divides (in common 
malaria) into sixteen 
germs which go out- 
side the cell and later 
enter fresh red cells. 
The chill comes on as 
this multitude of little 
creatures is set free 
into the blood liquid. 
When a mosquito 
draws blood from a 
malarial person, it 
sucks these germs into its stomach with the blood. 
They multiply in the walls of the mosquito's stomach and 
form many spores which pass to the salivary glands of the 
mosquito. When the mosquito pierces the skin of a person 
with its beak, it injects some of its saliva so that the blood 
can be pumped out more freely, and with this saliva it 
puts the malarial germ into the blood of the new victim. 




Courtesy of Prof. C. F. Hodge. 

School children of Worcester, Mass., spraying 
a pool by Beaver Brook. 



PREVENTION OF INFECTION: INSECT CARRIERS 139 

There are malaria carriers among the native citizens of 
malarial regions who harbor the germ without having the 
fever. Since the mosquito is necessary in the life cycle of 
the germ, the germ must disappear from the blood of 
malaria carriers if mosquitoes never reach them, hence 
the human malaria carrier is not as great a problem as the 
human diphtheria and typhoid carriers. 

The common mosquitoes probably do not fly over half 
a mile if not driven by hard winds or smoke ; hence a house- 




A useless mosquito bar (at left). An effective mosquito bar (at right) is tucked 
under the mattress all around bed. 



hold can obtain relief for a time by stopping the breeding 
of mosquitoes near them. One stray tomato can may 
breed enough mosquitoes to make a whole neighborhood 
miserable. Do not wait for the mosquito brigade, but do 
your share for the public good by pouring petroleum on 
any stagnant pools near your home ; also fasten wire net 
between two hoops and keep it on the rain barrel. See 
that the cistern is tightly screened, and that the gutter is 
not choked and holding water. Cut holes in tin cans, 
bury ink bottles, etc. 

A community cannot be rescued from malaria unless all 
cooperate for the common good. What are the breeding 



140 



THE PEOPLE'S HEALTH 



places of mosquitoes as revealed by the sanitary survey 
(see Experiment 12)? The smothering of wigglers (the 
early stage of the mosquito) by oiling the water destroys 
fish and other natural enemies, and unless the oil is ap- 
plied every ten days or oftener, if it rains, the mosquitoes, 
will become worse than they have ever been. The use of 
kerosene should be only a makeshift for the time. The 




Courtesy of Prof. J. E. Peabody. 
Staten Island marshes before and after drainage. 

mosquito can only be exterminated by general cooperation 
in destroying their breeding places. Places that cannot be 
drained must be filled in. The sides of drainage ditches 
should be kept upright. If tall grass and undergrowth in 
which mosquitoes take refuge during the day are destroyed, 
most of them will perish or be blown from the neighborhood. 
Houses may be fumigated by the use of camphor and 
carbolic acid in equal parts (the crystals to be dissolved 
by gentle heat) ; four ounces of the mixture will fumigate 
1000 cubic feet for two hours. Fumigation by the burning 




Life History of Malaria Parasite (Sedgwick) . i, 2, the germ which is put into human 
blood by a mosquito bite. — 3, 4, after entering red blood cell. — 5, 6, multiplying 
(fever begins). — 7, 8, forms of the germ before it is sucked from man's blood by 
mosquito. — 9. female germ cell in mosquito's stomach. — ga,gb, male germ cells. — 
10, union of 9 with one of the moving arms of 9 b. — 11. male germ resulting from this 
union in stomach of mosquito. — 12, 13, 14, 15, 16, dividing into spores and forming 
cysts on walls of mosquito's stomach (shown by 21). These spores become like 1, 
and pass to the mosquito's salivary gland, 22, ready to enter another human. This 
completes the cycle. — 17, female Anopheles mosquito, with head of male below (its 
feelers are more feathery). — 19, 20, mosquito larva and pupa. 




35 



-::"'. >•;- - • " c;„ ;< 



•« : *#*f> "' /■'-<< 







Pools left by a stream falling in dry weather. They should be filled in or drained or at 
least oiled every twelve days. 




Drain ditch dug to empty a standing pool. Look along railroad cuts and in lowlands for 
pools. Picture from Herms' " Malaria, Cause and Control." (Published by Macmillan 
Co. This is a useful guide in an anti-mosquito crusade.) 



PREVEXTIOX OF IXFECTIOX: IXSECT CARRIERS 



J 43 



of sulphur is preferable if there are no gilt picture frames to 
be tarnished. 

Imperfectly fitting or neglected screens are a danger. A 
certain family never had a case of malaria so long as they 
slept under mosquito nets at night. Later the house was 
screened and the bed netting discarded. The family soon 
suffered from malaria, for the screens did not exactly fit 
the windows. 

The Yellow Fever mosquito, because of the white bands 
upon its legs and its striped body, is sometimes called the 
tiger mosquito. This is the little insect that prevented 
the French from digging the Panama Canal ; 240 of their 
laborers in every 1000 died each year of yellow fever. But 
the loss was only 7^ per 1000 during the years the United 
States were digging it. This was after the discovery that 
mosquitoes were carriers of yellow fever ; millions of 
dollars were spent in destroying their breeding places on 
the Isthmus. 

This mosquito is not infectious to man until twelve or 
fourteen days after taking its meal of blood from a yellow 
fever patient ; and the man is not infectious to the mos- 
quito except during the first three or four days after the 
onset of the fever. 

The germ of yellow fever has never been discovered. 
The proof that the mosquito is the carrier of the unknown 
virus of yellow fever is one of the most heroic chapters in 
the history of science. Dr. Lazear, one of the four physi- 
cians appointed by Surgeon-general Sternberg to seek the 
cause of yellow fever, permitted an infected mosquito to 
bite him. He became ill with the disease in a few days 
and died. Volunteers for further experiment were then 
called for among the soldiers in Cuba. John R. Kissinger, 



144 



THE PEOPLES HEALTH 



a private from Ohio, was the first to respond. John J. 
Moran also volunteered. Major Reed explained the 
danger of suffering and death which might come, but, seeing 
they were determined, he offered compensation in money. 
Both young men declined it, Mr. Kissinger saying that they 
volunteered solely " in the interest of humanity and the 
cause of science." Major Reed touched his cap, saying, 

" Gentlemen, I salute you." 
Reed afterwards wrote : " In 
my opinion this exhibition of 
courage has never been sur- 
passed in the army of the 
United States." Both went 
into a room and allowed them- 
selves to be bitten by mos- 
quitoes that had bitten yellow 
fever patients. On Christmas 
morning ( 1 900) John J. Moran 
was stricken with yellow fever 
and had a sharp attack. He 
bore it without a murmur. 
In the next room three brave 
soldiers slept for twenty nights 
in close contact with the soiled clothing which had been taken 
from the beds of yellow fever patients, some of whom had 
died of the disease. These men remained in perfect health. 
Thus was it proven that yellow fever is not transmitted by 
contact, but indirectly through a certain kind of mosquito. 
There are three ways of preventing yellow fever and 
malaria: 1. Destroy breeding places of mosquitoes. 
2. Keep mosquitoes from biting you. 3. Prevent mos- 
quitoes from becoming infected by screening patients. 




John R. Kissinger, U. S. Army. 



PREVENTION OF INFECTION: INSECT CARRIERS 



145 



In earlier chapters you learned of the part played by 
water and milk in conveying typhoid fever. The House 
Fly is another carrier of typhoid germs ; indeed, Dr. Howard 
has named it the typhoid fly. Many cases of typhoid 
fever occur because flies go from poisonous human dis- 
charges to crawl on meat in a market 
or on the food of a dining table. Dr. 
Jackson found that flies were attracted 
by sewage floating in the slips between 
the wharves of New York harbor. He 
also showed that the majority of 
typhoid cases were in the parts of the 
city nearest this polluted water front. 
/;/ the Spanish war officers whose mess tents were pro- 
tected by screens suffered less from typhoid fever than 
those whose tents were not so guarded; and in the fall 
the new cases suddenly diminished when most of the flies 
were killed by frost. This suggests that screens should 




Foot of Fly : an ideal 
germ carrier. 




Assistant Health Officer of Washington counting flies by measuring them (3200 
to a pint) in the Evening Star campaign. 



146 



THE PEOPLE'S HEALTH 




not be taken from windows until after severe frost ; other- 
wise flies may find a warm refuge for 
winter instead of being frozen. 

The house fly, or filth fly, may carry 
a variety of disease germs. Pus germs, 
The two stages between egg ms of leprosy diphtheria, and con- 

and house fly. 1, larva (or ° c J 7 r 

maggot) above; 2 pupa, below sumption have been found on its 
hairy legs. Flies often eat too much 
and then vomit. Many fly specks are vomit stains. 

The house fly prefers to breed in horse manure. It will 
also breed in moist, rotting waste paper, trash heaps, and 
human excrement. Within twenty-four hours after the 
egg is laid, it hatches into a small footless white maggot 
which grows and turns into a brown pupa, and this becomes 
an adult fly within ten days after the egg was laid. One 
way to stop their increase is to 
spread the matter in which they 
breed upon the fields once a week 
so that it will dry and the eggs and 
young perish, for they develop only 
in fermenting material. Manure 
left in heaps should be carefully 
screened. If only one or two 





The best way to prevent the breeding 
of flies and escape their dangerous work 
is to keep the premises clean. 



A Bat roost, designed by a 
citizen of the Southwest. Other 
enemies of disease-bringing in- 
sects (and friends of ours) which 
should be helped are birds, frogs, 
lizards, spiders, dragon flies. 



PREVENTION OF INFECTION: INSECT CARRIERS 



147 



horses are kept, the manure can be thrown into a covered 
barrel or box which will keep it fly-tight until it is 
removed. Because of their rapid multiplication, killing 
a few flies in May may mean millions less in August. A 
carelessly managed stable 
may bring the efforts of 
a whole neighborhood of 
fly fighters to naught. 
The efforts of one family 
will amount to little, un- 
less their neighbors take 
equal pains. A farm 
household with no near 
neighbors can stop the 
fly pest with their own 
efforts. 

Most public appeals for 
fighting flies end with the 
slogan " Swat the fly." 
This is a good motto, but 
a better motto would be 
" Starve the fly." This 
can be done by thorough 
cleanliness. No food 
should be placed within 

their reach ; the cover should always be on the garbage 
can. The starving can best be done in the earlier stages of 
the fly's life. Give them absolutely no place in which to 
breed. Where there is no filth, there are no flies. 1 

l \ Letter adapted from Bulletin of Indiana Board of Health. 
Dear Citizen : 

I am a fly, now. Once I was a maggot. I live on garbage and slops 
and stable filth. 

I carry all kinds of filth and disease on my hairy feet. This I wipe off 




Courtesy of Mr. Warren H. Booker, North 
Carolina Board of Health. 

Simple and very successful fly trap for a 
garbage can. Cloth curtains turned up to 
show cleats. It catches the flies outside the 
house. Flies enter the garbage can between 
the cover and the can, and also around the 
edge of the trap placed over a two- or three- 
inch hole. After feeding they fly toward the 
light and come out this hole in the cover 
into the trap. 



148 



THE PEOPLES HEALTH 



Roll op the 
Guilty. 



0/> Wot/ 



Infantile Paralysis. — How to prevent it and how to 
help Recovery from the Effects of It. — Although described 
in this chapter on insect-borne diseases, this disease is also 
spread by human carriers both sick and well. Infantile 
paralysis was probably more common years ago than any 
one reckoned. Little children fall and get 
hard bumps almost every day, and when 
the effects of this disease began to show 
there was always some recent bump or fall 
by which to explain the strange lameness or 
inability to walk. Cases of " brain fever," 
weak backs, or feebleness of an arm or leg 
were often unrecognized cases of infantile 
paralysis. 

It is believed that the disease may be 
carried by the house fly. After contact with 
the nasal or throat discharge of the sick 
child, the fly goes to an exposed scratch or 
open sore in the skin of another child. It is 




Anopheles mos- 
quito (malaria). 



<>»Wo// 




on the sugar bowl or the baby's bottle when I come to 
see you, or wash off when I take a bath in your coffee 
cup or your glass of milk. 

I cannot live where there is no filth. I think you 
must love me because you have kept sudi nice nasty 
places for me to live in. I hope you will do nothing to 
disturb your filth so that I may be with you again next 
year. The fact is, I have already laid many eggs in your 
refuse, and if you do not destroy my babies, many millions 
of us will be ready to call on you again. 

I shall take no offense if you have screens. They are, 
I know, quite the fashion. They have many convenient 
cracks and the door screens are often open. All we ask 
is to be allowed to hatch out in our usual haunts, and 
we promise to dine with you every day. 

Good-by till we meet again, 

A House Fly. 



Stegomyia (yellow 
fever). 



W 

m 



Bed bug (typhus 
■ fever). 




Flea (the plague). 




PREYEXTIOX OF INFECTION: IXSECT CARRIERS 149 

believed that the biting fly more often carries the germ and 
inserts it when it pierces the skin to suck blood. Professor 
Rosenau let biting stable flies bite monkeys having the 
disease and later he let these flies bite twelve healthy 
monkeys. Six of them developed the disease in ten days. 
r dll— continued The (Usease i s most common in children 

from two to six years of age, possibly be- 
cause they go with arms and legs bare. 
It is probably also carried by droplet in- 
fection. A healthy carrier may send the 
germs into the air when sneezing or cough- 
ing, and the germs may be drawn at once 
paralysis). into the nose or throat of another. The 

biting fly breeds in manure heaps. Regular 
removal of .manure, and other measures 
for preventing house flies, will also help 
- 1 ' 5 ' to do away with the biting fly. This fly 

is about the same size as the house fly, 
House fly (typhoid but has a long bayonet-like beak ; it rests 
with its head up and its abdomen and 
wings slanting towards the supporting 
V^* surface: The fewer the stables, the less 
of these two kinds of flies we will have. 
Horses, a few years hence, will probably 
not be allowed to enter residence districts 

Western wood tick 

(spotted fever). in our cities. 

s^. When the disease is epidemic, children 

should wear frocks cut high in the neck 
and long, loose pantaloons, since the fly 
bites through stockings. During this time 
the war against dust and flies should be 

Body louse (relaps- 
ing fever), redoubled. Patients should be isolated for 






150 THE PEOPLES HEALTH 

three or four weeks, and brothers and sisters of a patient 
should not attend school. The discharges from the nose 
and throat should be disinfected. 

To help recovery the patient should be kept in rest and 
quiet for a month ; then the child should live out of doors 
as much as possible, sleep in the open air except in severe 
weather, and the weakened limb or part should be massaged 
and gently and gradually exercised. Thus the use of the 
limb will be regained. 

Rocky Mountain Spotted Fever. — The infection of this 
very fatal disease is borne by the wood tick. In the 




Stages in the life of the Wood Tick that carries the germ of Rocky Mountain 
Spotted Fever. In the first stage it has only six legs. In the last stage it is shown 
gorged with blood. (Enlarged.) 

earlier stages of its life the tick lives upon squirrels and 
other small animals ; in its adult stage it lives upon cattle. 
The disease occurs in several western states in a mild 
form; the most dangerous form is confined to the Bitter 
Root Valley of Montana. The infection is fought by 
destroying the ticks. This is to be done, as in the case 
of the cattle-fever tick, by dipping the infected cattle into 
a kerosene solution, thus killing the ticks. 

Many causes have been assigned for Pellagra (" rough 
skin "). Some think that it is caused by a monotonous 
diet of rotten or musty corn. Avoid corn grown in a cool 



PREVENTION OF INFECTION: INSECT CARRIERS 151 

climate where it does not ripen thoroughly, or corn har- 
vested by cutting the entire stalks in the green state and 
piling them together in fields. Not even horses should 
eat corn that is not thoroughly sound. Some think pella- 
gra is carried by the tiny sand fly or gnat. Recent inves- 
tigations in the Carolinas seem to show that it may possibly 
spread by the biting fly, the same fly which is believed to 
carry the germ of infantile paralysis. 



Which would you rather 
have in your town 



This? 



or This? 




Muzzling Law. By enforcing this law for four years England caused rabies to 
disappear. Germany is doing the same. Rabies is increasing in the United States. 
Can we not enforce this law, save lives, and much terrible suffering of dog and man? 



Rabies is a disease spread by neither human nor insect 
carriers, but chiefly by the dog, man's faithful friend. We 
should be suspicious of a dog that shows change of dis- 
position, alteration of voice, inability to swallow, leaves 
home and returns exhausted and thin, has paralysis of the 
jaw, or swallows wood and stones. Such a dog may have 
the furious type of rabies. There is also a dumb type with 
similar symptoms, except that the dog is not very irri- 
table, and paralysis appears early. Rabies has been increas- 
ing for some years in the United States. The head of a 



152 THE PEOPLE'S HEALTH 

suspected dog may be sent for examination and the Pas- 
teur treatment may be obtained for patients from Pasteur 
Institutes or State Health Boards at the following places : 
New York City, Chicago, Baltimore, Richmond, Atlanta, 
New Orleans, Houston, Austin, Pittsburgh, Ann Arbor, St. 
Paul, St. Louis, San Francisco. 

Test Questions. — How are animal disease germs carried ? What 
disease may be brought by the spotted- winged mosquito ? Describe 
the possible effect of a mosquito-breeding mill pond upon a country- 
side. Give the history of the discovery that mosquitoes carry ma- 
laria. How does the mosquito affect a human being with the germ? 
What is said of malaria carriers ? How far does the common mosquito 
fly from its breeding place? Describe the means of getting rid of 
mosquitoes. What is said of screens? 

Describe the yellow-fever mosquito. Compare it with the malaria 
mosquito. (Figs.) What effect has this mosquito had on the Pan- 
ama Canal ? Tell how the proof was obtained that it conveys yellow 
fever. How was it proved in New York City that the house fly 
carries typhoid? What proof was obtained in the Spanish War? 
Where does the house fly breed? Tell its life history. How is it 
best kept down? (Flies travel 700 yards from the breeding-place; 
a few go a mile.) 



CHAPTER IX 

HYGIENE OF WORK AND PLAY 

The recent growth of cities and factories has not been 
favorable to public health. Chronic diseases, especially of 
the nerves, kidneys, and stomach, have had a more rapid in- 
crease in the last fifty years than has ever been known before. 
The triumph of public sanitation is ail the greater that, in 




Photograph by Miss Ellen Hope Wilson. 
Camp fire girls dancing. 

spite of weakened individual life, infectious, or germ, 
diseases have greatly decreased, and the average length of 
life shows a marked increase. Chronic diseases are more 
common because of the artificial conditions and strain of 
civilized life, acute diseases are fewer because of successful 
work in public sanitation. Men in cities work too much 

iS3 



154 



THE PEOPLE'S HEALTH 



with their tongues and brains and not enough with their 
bodies. This is unfortunate, because there is no good 
brain work without body work. 

People who live in houses as closely as moles live in 
burrows become pale and flabby for want of sunshine. 

Human beings are not suited to spend most of their lives 
sitting in chairs. The growth of baseball, football, and other 
sports has been favorable to health. However, fewer and 




Courtesy of C. N. Millard, 
Riding a bicycle in a posture which squeezes the lungs. 



fewer play them. The office worker and machine tender 
need the activity of the games but they hire others to play 
while they sit on a plank and yell. Since they are in out- 
door air, this yelling is, of course, fine for their lungs. 

Indoor workers in towns and cities should so locate their 
homes that they will be compelled to walk several miles daily 
to and from their work, or from the cars that take them 
to their work. If the distance to the work is too great to 
walk twice a day, it will be well to walk one way and ride 



HYGIENE OF WORK AND PLAY 1 55 

one way ; thus will daily exercise out of doors be insured. 
Unless the manner of living has been so arranged that 
exercise is absolutely necessary, it will usually be neglected, 
as has been proven in millions of cases. Man has not yet 
attained the broad and reasonable view of life that assigns 
to health its proper place. If there is any chance at all, 
health will be neglected for want of time, amidst the hurry 
of modern life. As a boy studying hygiene wrote: 

" A walk for a mile in the open air 
Will save you more than a nickel fare, 
And bring you more of vigor by far 
Than you can get in a stuffy old car." 

To develop the lungs use the legs. A good carriage of 
the body is one of the greatest helps to health. This means 
to walk with the chin in and the chest up and the hips 
back. (The head should not be drawn back.) Only in 
this way can one get the full benefit of exercise and breath- 
ing. To walk with the toes out (" slew-footed ") wastes 
energy. Tight clothes and especially corsets restrain the 
growth of the muscles of the back. A strong spine is the 
true secret of a good figure. It gives a well-poised head 
and easy carriage. 

Man has devoted so much attention to lifeless machines 
that he has sadly neglected the living human machine and 
failed to keep it up to its natural, original standard. Town 
dwellers and domestic animals have small hearts compared 
to rural dwellers and wild animals. The physiology of 
exercise is explained in the author's " Hygienic Physiology,'' 
pages 62-67 and 98-99. Here we cannot do better than 
adapt a statement of Leonard Hill, a great English physiol- 
ogist : There is nothing so terrible in its effect on health 
as neglect of exercise in the open air, and nothing equal to 



^ 



THE PEOPLE'S HEALTH 



such exercise in restoring soundness, beauty, and happiness. 
Every muscle fills with blood as it relaxes, and squeezes 
this blood on past the valves in the veins as it shortens. 
Each muscle together with the valves in its veins, to pre- 
vent a back flow, forms a pump to help the heart circulate 
the blood. The heart sends the blood to the capillaries; 



HI m 

SBm wM si vJli\ < ■ill 


pKIl 



Courtesy of Dr. C. Ward Crampton, Director Physical Training, New York City Schools. 
Chinning is good for the arms, chest, and spine. 

it is the work of the muscles to bring it back to the heart. 
Nature arranged the circulation for a restless, moving 
animal. Mankind becomes diseased by attempting to 
lead a life unsuited to the nature of the body. With rapid 
exercise, the breath becomes deep, the liver is squeezed 
like a sponge at each breath, and the organs in the abdomen 
are thoroughly freshened by being kneaded between the 
sheet-like midriff (diaphragm) above and the stout muscles 
forming the walls around the abdomen. The brain worker 
is kept in a nervous state by his habits of life. He thinks 



HYGIEXE OF WORK AXD PLAY 1 57 

of doing things, yet he scarcely moves; his heart and 
blood vessels are tightened, his breathing shallow, his 
digestive organs sluggish and weak because they are no 
longer stirred and freshened. In many cases he tries to 
obtain relief from meanness of spirit and dull sameness of 




Courtesy of Toledo School Board. 
Playground with wading pool, Toledo, Ohio. 

life by the use of alcohol, tobacco, drugs or highly seasoned 
food. The whole life of his body runs on a lower plane of 
action. 

Women in towns and cities are usually weaker than the 
men. They are in the house more ; housekeeping is 
tedious and hard because the house is not simply furnished, . 
the family simply clad, nor the table supplied with simple 
food. Woman's work does not call for great vigor, yet it 



i58 



THE PEOPLE'S HEALTH 



is constant and tedious. The women who do no work at 
all, but spend much time fretting with servants, have even 
worse health. Muscular work is absolutely essential to 
woman's health, and some of it should be vigorous enough 
to cause the lungs to expand fully and the blood to flow 
fast. The abdominal organs, for the reason you have 




Photograph by Miss May Belle Brooks. 
Washing in the wrong way bows the back and flattens the chest. Notice the 
higher bench at the right and that the washer expands the chest and bends at 
the hips. 

learned, are liable to stagnation if the life is so inactive 
that they are not stimulated by full breathing ; shallow 
breathing causes clogged intestine (constipation). A daily 
grind of gentle tasks is not best suited to encourage the 
cells properly to assimilate food. 

The phrase of a woman being " fair, fat, and forty " 
usually means being fat and forty; but by right living 
she may be fair at forty and to a far greater age. The 
more a woman eats, the more exercise she should take. 



HYGIENE OF WORK AND PLAY 



159 



Some hygienists think that it is the lack of lively, vigorous 
work that makes civilized woman so delicate. Others hold 
that the chief cause is her manner of dressing. Doubtless 
both are to blame. If the clothing is not loose and com- 
fortable, lively, vigorous work will be shunned. 




Courtesy of Dr. C. W. Crampton, Director Physical Training, New York City. 
Russian Folk Dance. 

Physical culture has become a settled, public policy in many 
intelligent communities. Playgrounds and parks are mul- 
tiplying. Games and play make children self-reliant and 
original if the play is not closely supervised by an adult. 

Every one must learn to be his own manager in arrang- 
ing for healthful habits. This book will be studied in 
school at about the time of life when a boy or girl will, if 
ever, come to a full determination to develop and pre- 



i6o 



THE PEOPLE'S HEALTH 



serve the body. To do this, one must avoid doing like 
those silly people who try to follow all the fashions, but 
must choose to form habits suited to health and the needs 
of life. One should go in for some athletics, but not try 
for immense development if the life is to be chiefly an 
indoor one. Big unused lungs and heart give no advantage, 
but in fact are a disadvantage, for they soon degenerate. 




Courtesy of Nat. Child Labor Committee. 
Making artificial flowers indoors instead of gathering natural ones outdoors. 
The pay is 5 cents for 500. 

Violent exercise in youth, followed by inactive life, is not 
the best course. What is needed is moderate exercise all 
through life. 

Violent exercise may be continued as long as breathing 
with the nose is possible; it must be stopped before the 
face becomes pale. If you become so out of breath that 
you have to open your mouth to breathe, you should stop. 
If the exercise has not been overdone, the pulse will return 
to its normal beat within fifteen minutes. If not urged too 
fast, the heart acquires new strength by exercise. 



HYGIENE OF WORK AND PLAY 161 

While seeking physical development in the holidays, one 
must not start out on long tramps the first week, if unused 
to much walking. Boy scouts sometimes sleep next to 
the damp ground and usually suffer from it. 

The skin should be tanned gradually. Quick tanning 
may injure it. 

Few, if any, can trust themselves to live right by daily 
will power; besides, constant exercise of the will would be 
a nervous strain. One should so arrange his work, his 
home and his duties, as to make it necessary to live right. 
A feeling of restlessness should not be resisted, but relieved 
by outdoor life ; thus the body will be spared injury. 
The play instinct, the restless feeling, and the feeling of 
fatigue, or instinct for rest, exist as safeguards; yet mam- 
deaden these instincts with narcotics that they may keep 
on their way for a while longer. Beer, coffee, tobacco, 
dull the sense of pain so that one goes on using up the 



Percentage of eacli class entered 




Courtesy of Set. Temperance Federation. 

A Sixty-two Mile Walking Match in Germany. Non-abstainers from beer, 
etc., at left, abstainers "at right. A majority of the drinkers fell out. Germany's 
poor showing in the Olympic games at Stockholm has been attributed to beer. 

body's strength, but thinks the strength comes from the 
narcotic. 

During marked fatigue we are being smothered and 
paralyzed by our own waste products which are formed by 
the burning taking place in the body. Mill workers and 
housekeepers, because of long, monotonous work without 
rest, often become rheumatic. Long fatigue without times 
of refreshing is a fruitful cause of rheumatism. There is 



l62 



THE PEOPLE'S HEALTH 



no use for the mother of a family to work until she is so 
weary and worn out that her presence has a depressing 
influence upon the family circle ; it lessens her present and 
future usefulness. There is often a tragic breaking down 
of factory workers who are then cast aside like old iron 
thrown to the scrap pile. The breaking down comes 




Courtesy of University of Wisconsin. 
A crooked spine (notice shoulders). Exercise for straightening spine. 



quicker to those who work in close, warm, impure air, and 
in restricted posture over desk or machine. To overdo 
either athletics or daily labor will shorten the life. 

The heart beats faster during severe exercise so as to 
send the much-needed oxygen to the tissues. When the 
heart squeezes out the blood, the arteries are stretched by 
the rush of blood ; they, in turn, force the blood on and 
become small. In the muscles the iron in the red cells, 
which is the oxygen carrier, gives up oxygen to the tissues 
and the red cells become darker, giving all the blood a 
darker tint. The muscular strength, and especially the 
endurance, depends upon elastic, healthy arteries. The 



HYGIEXE OF WORK AXD PLAY 



163 



body should stay supple and graceful, not only long after 
the fortieth but after the fiftieth 
and in many cases the sixtieth 
year. 

Any one who habitually slouches 
along and flops down in a heap 
will lose good tone of the muscles. 
Those who stand straight and 
carry themselves well will find 
themselves thinking straight and 
feeling well. Digestion puts the 
food into the blood but it will 
not pass into the cells unless it is needed. Work or exer- 
cise causes the cells to need food. The person does not 
live who can thrive without plenty of exercise. 




Courtesy of Univ. of Wisconsin. 
Exercise for poise and carriage. 



Test Questions. — Have germ diseases increased or decreased in 
recent years? Have other diseases increased or diminished? Ex- 
plain why. What has been the effect of sports? How should the 
life be arranged for needed exercise ? Why ? How do the hearts of 
most city and country dwellers differ ? What, according to Leonard 
Hill, is the nature of the body ? How does a muscle move the blood ? 
Why is exercise a benefit ? 

How is woman's health affected by modern life? What kind of 
work does a woman need for health ? What are the two chief causes 
of so many women being out of health ? For whom are large muscles 
and large hearts not desirable ? What is the caution about holidays ? 
When exercising, what sign warns not to go beyond a safe limit? 
What is said of a feeling of restlessness? What is said of the play 
instinct? Does the manner of standing and walking influence the 
thinking ? 



CHAPTER X 
MENTAL HYGIENE 

Disease is a condition of disorder. When the body is 
out of adjustment to the conditions amidst which it lives and 
is striving to readjust itself, it is said to be diseased. Dis- 
order of the nerves is increasing because civilized man lives 
too fast, crowds too much work, too much play, too much 
excitement, into a day. Nervousness results because of 
lack of quiet and of too much indoor life. " Nightmare " 
often follows " daymare " ; it comes because of excitement 
during the previous day. When a person finds that he 
cannot sleep, he ought to do some physical work out of 
doors daily. The outrageous custom of confining children 
in closed rooms most of the day makes even young children 
nervous. 

To take little things hard and magnify them entirely 
beyond their importance is a sure sign of nervousness. In 
many cases the only remedy for nervousness is to stop worry- 
ing and to rest, but this is the very remedy such people 
refuse to take. Mental tension means muscle tension. 
It is best to spend an hour or' two each afternoon in peace 
and quiet and allow full time for sleep at night. Overwork 
for the sake of others is not so dangerous as overwork for 
one's self ; but to slave for one's family and not have enough 
energy left to be pleasant and happy around the hearth- 
stone at night is a wrong, both to the family and one's self. 
Only he who is sound and healthy can be tranquil and 

164 



UEXTAT. HYGIEKE 



l6 5 



superior amid many cares. " He that would be good 
must be happy, and he that would be happy must be 
healthy.'' 

Mental health and mental disease are " catching." The 
herd instinct, or instinct to go with the crowd, causes us 
to be easily affected by the mental and bodily states of 




Boys playing on roof of a New York public school. Games train in self-control, 
alertness, decision of character, fairness. 

others. Coughing in an assembly makes others cough. 
A fidgety pupil should never be placed on a front seat. 

Cheerfulness is a great help to good health. It is an 
essential condition of a healthy home or school. Cheer- 
fulness keeps one from getting tired. In some factories 
workers should be allowed to talk and sing at their work. 
Worry not only makes one look elder ; it makes one really 
older. Beauty is more than skin deep, for it depends upon 
a merry heart, a steady mind, and a loving soul. Work is 



i66 



THE PEOPLES HEALTH 



the best cure for the blues ; it keeps one from thinking of 
one's self. Those who live in the present are not anxious 
for the future. 

A fretter is easily upset and upsets others who have to 
be with him. The habit of fretting is like the drink or drug 
habit ; every time you give way leaves you weaker and 





1 


1 H 

Jmwfr f 


: ' ■■^'■' : ^-t 


... ': , ■ 
P, 





Permission of " Little Folks," Salem, Mass. 
" We've got the measles " — (but are still happy). 

less able to resist the habit the next time. It is best to 
keep one's bad states of mind to one's self. There is nothing 
that makes troubles grow like thinking about them and 
talking about them. Shun the habit of giving vent to 
each passing feeling. Its importance is usually fanciful 
and comes from magnifying trifles. It is our duty to the 
public health not to scatter abroad thoughts of weakness, 
fear, and sadness. 

Thoughts are as important as germs in their effect on 



MENTAL HYGIENE 



167 



health. Did you ever notice the halting breath of the 
fearful or the shallow, cramped breathing of the despondent ? 
A nervous person who is bitten by a dog that is not really 
mad, but only believed to be so, may have a disease called 
false rabies, and even die of it. 

The nervous system is the balancing power in the body. 
The currents up the nerves of feeling and down the nerves 
of motion pass through nerve centers in the spine and brain 
and are modified and harmonized in those centers. The 
state of the nervous system varies with the thoughts. 
Some recover from dangerous illness, and others die of less 
dangerous illness, when the only difference noticeable is a 

1st Series. No Alcohol — Average No. of Hits 23 



■■■ 2d Series. Alcohol Taken — Average No. of Hits 3 
3d Series. No Alcohol — Average No. of Hits 26 

Courtesy of Scientific Temperance Federation. 

Rifle Shooting in Sweden, showing the effect of alcohol upon steadiness of nerve. 
Length of black bars shows average number of hits of soldiers in 30 shots, three 
tablespoonfuls of alcohol being taken on the second day. 

different mental attitude. It is believed that when you 
think of a part of the body, for example the face, the 
nerves cause the amount of blood in it to be increased. 
The amount of blood in different parts of the body at 
different times is controlled by nerves that go to the walls 
cf the blood vessels. The stomach, when at work, needs 
several times as much blood in its walls as at other times. 
Excited feelings can cause indigestion. The human ma- 
chine when sound is the most economical, perfect, and 
beautiful of all machines. Man's brain and nerves are 



1 68 THE PEOPLE'S HEALTH 

the most highly developed among animals. That man is 
straining the balancing power in the nervous system is 
shown by the number of impaired minds and by the many 
that are threatened with mental breakdown. Nearly 
200,000 persons in the United States have unsound minds. 
One out of every 200 people either has had or will have 
disorder of the mind. Asylums for mental disorders have 
no vacant rooms. Those with diseases of the nervous 
system are the most numerous class of sick cared for in 
hospitals. Many, if not most of them, might have kept 
their minds sound if they had known certain facts of mental 
hygiene and acted upon them ; for, as a rule, mental dis- 
orders come on very gradually. 

It is believed by many that the foundation for an uncon- 
trollable temper lasting a lifetime, is usually laid in infancy. 
If a baby's habit of getting into tantrums is not corrected 
by the time it is a year old, the chances are against ever 
correcting it entirely. If not corrected in childhood, it 
will probably remain a deplorable weakness through life. 
Good habits can best be formed while the body is tender 
and the nerve cells are growing and forming new branches 
to connect with other cells. Monotonous steadiness is not 
the only good way of working, however. Some people 
work best by spells, with periods of complete rest between. 

Nervous, irritable weakness in the home is a sign that a 
family stock is becoming degenerate; it is the first step 
the mind takes in acquiring a wrong twist. 

Nervousness is not only caught by association and by 
bad training, but it may be inherited. Those who believe 
in public hygiene care also for race hygiene, or hygiene that 
will help future generations. If a person is born or grows 
up with an unsteady nervous system, his influence will 



MENTAL HYGIENE 169 

not only be a handicap to the community, but some of 
his children will inherit his bad nervous system. It should 
be known to all that if two imbeciles marry, their children 
will be imbeciles; when imbeciles marry normal persons, 
about half the offspring are feeble-minded or degenerate. 
When both parents are industrious, nine tenths of the 
children may be industrious. When both parents are indo- 
lent, three fourths of the children may be indolent. 

The marriage of people of unsound or feeble mind is a 
great evil that should be stopped. Defective parents cause 

Dji I 1 1 i i i ih# 

A 'ALCOHOLIC 

# ■feebleminded 

Family Chart : A Feeble-minded Woman married a Drunkard ; they had 
eight children and nine grandchildren. How many of them were drunken or feeble- 
minded ? A grown idiot is mentally 3 years old, an imbecile between 4 and 7 ; feeble- 
minded are between 8 and 12. 

the race to degenerate. Vitality depends upon two things, 
habits and heredity. The father who objects to his son 
marrying a tuberculous woman, and the mother who opposes 
the marriage of her daughter to a young man who drinks, 
are acting the part both of good citizens and of good parents. 
Some ministers, careful of the welfare of the race, refuse to 
marry couples when each does not show a certificate of 
sound health. The children of healthy parents are more 
likely to be sound and strong than the children of sickly 
parents. 

An average community of one thousand persons has 



170 THE PEOPLE'S HEALTH 

four insane persons. For the sake of race protection and 
betterment, the marriage of the insane, of criminals, 
paupers, inebriates, opium and cocaine users, should be 
restricted. The need of this is plainly shown by the science 
of eugenics, which means the science of beginning well. 
Such degenerate persons are called defectives. They are 
most numerous in remote country districts and among 
the very rich in cities. 

Local health officers in most states are required to report 
the feeble-minded and epileptic to the state health depart- 
ment. By the regulation of marriages, insanity would 
practically disappear, or at least very little of it would 
remain. 

One who inherits an unsteady nervous system has a 
predisposition to form faulty habits. One who has a weak 
nervous system from the start will become stronger amidst 
right associates. By cultivating the right mental attitudes, 
by not giving way to excitement, we as a people will come 
to think better, feel better, and act better than we do now. 
Sounder nerves mean longer life, more efficient work, a 
greater number of hale, happy old people. 

Precocious children should be guarded against strain. 
Many children that appear to be dull are capable of longer 
and higher development than very bright children. A 
child who has a very active mind with quick and eager 
brain processes, but whose body is weak, may exhaust 
himself early in life and become commonplace, while a 
slower child goes on to great personal achievements or to 
great social usefulness. 

A plain proof of the lack of self-control is the use of 
narcotics to deaden and stimulants to excite. There are 
many natural nerve stimulants; among these are fresh 



MENTAL HYGIENE 



171 




air, sunlight, cold, heat, change, interest, and emotion. 
There are natural narcotics, such as monotony, gentle 
warmth, fatigue, and especially the gas called carbon 
dioxid which is formed by the burning always going on 
in a living body. 

Man deprives himself of natural stimulants by his 
artificial life, and attempts to control himself by smoking, 
drinking, and the use of e^^ 
drugs. A drug is any- 
thing taken to stimulate 
and regulate the body 
with the view of control- 
ling the body or curing 
disease. On the other 
hand, foods are taken be- 
cause of their nourishing 

This figure shows the amounts of alcohol 
qualities. Alcohol, spices, in a drink of beer, whiskey, and wine. The 
. . , difference is very slight. 

opium, quinine, are drugs. 

When an artificial stimulant or narcotic which has been 
used for a while is left off, the body misses its effect and 
there is a craving for it. Hence such things lead to the 
formation of habits. 

Drug habits begin with the use of small amounts which 
are gradually increased. Such habits make one more 
liable to the infection of disease germs. The little white 
soldiers in the blood become drunken and stupid because 
of alcohol or opium, and are asleep at their posts when 
danger comes. 

Many of the so-called soft drinks contain two habit- 
forming drugs, cocaine and caffeine. There are about 
thirty " cures" advertised for catarrh, asthma, colds, and 
consumption now on the market that contain cocaine. 



172 



THE PEOPLE'S HEALTH 



The millions of dollars collected by patent medicine manu- 
facturers are a measureless expense to the nation, for the 
only true wealth and greatness of a nation consists of strong, 
wise people. Such things kill men or wreck their lives. 

The patent medicine fraud is doubtless the greatest 
fraud to be found in the world. It could not exist but for 
the lingering belief of mankind in magic and voodoo. The 
man who practices self-drugging would not attempt to 




This figure shows that the drinking of spirits in the United States has decreased 
and the drinking of wine and beer has increased. Because of the great hurry and 
strain of modern life the use of alcohol has not decreased. Those who cultivate 
cheerfulness and kindliness feel no need for a narcotic. 

repair his own watch, which is simplicity itself compared 
to the human body. The poisons in plants are not there 
for the use of animals ; they are formed by the plants to 
prevent animals eating them. The really curative drugs 
are of the body's own making. The cruelty of these shame- 
less frauds is the most terrible part of it. A diseased man 
will be caught by anything that gives the faintest hope. A 
sufferer with a cancer will believe any lie that offers hope. 
Thousands of dollars are filched from poor consumptives 
who need their every dime to buy food and to follow 
advice from careful doctors that so they may obtain con- 
ditions which will allow nature to cure them. 

Patent medicines contain no secret remedies. You can 



MENTAL HYGIENE 



173 



buy a book (" Nostrums and Quackery ") for 25 cents, 
which gives the composition of every one of them. A 
" rheumatic cure " is found to be a little rhubarb and 
alcohol; a " hair grower " is made of a little borax and 
glycerin. One who is ignorant enough to believe in a 
" skin food " will believe in almost anything. A restorer 
of youthful complexion contains glycerin, red coal tar dye, 
and alcohol. An " electric " belt contains a penny magnet, 
an " obesity cure " a harmless but useless powder. 

The advertisements of these professional liars and 
thieves are not stupidly written, but are worded with great 
skill to frighten and deceive. They can persuade a man 
with a pain in the muscles of his back that he has a dan- 
gerous kidney disease. 

After the passage of the pure food and drug law, an 
alcoholic remedy which was known as the " temperance 
man's booze " could not be sold unless the amount of 
alcohol was stated on the bottle. It was found to contain 
more alcohol than brandy. A fig laxative had senna, 
which had all along been the principal drug, added to its 
label. The law prevents lies on the label in most cases, 
but it has no effect upon the falsehoods in drug advertise- 
ments in the newspapers, nor on circulars distributed sepa- 
rately from the bottle. The straightforwardness of any 
newspaper containing many patent medicine advertise- 
ments is to be doubted. 

The law should be so amended that soothing sirups and 
other medicines containing morphine, cocaine, or other 
poison should be marked with a skull and cross bones ; 
such drugs to be sold only on a physician's prescription, 
to be filled only once and a record kept of the sale. 

There have been hundreds of cases of poisoning by 



174 THE PEOPLE'S HEALTH 

acetanelid. Some of them resulted in death. The follow- 
ing is a sample newspaper report : " Physician called to 
Miss Black. Headache tablets nearly fatal." Here are 
notices about the effects of other patent medicines : " Over- 
dose of liver pills — thirteen in a few hours — kills Ben 
Rosen." " Took Spring tonic and died." " Infant is 
killed by soothing sirup. The drug may be barred from 
Wyoming." " Patent medicine kills Indian. A Choctaw 
near Marlow drank a bottle." " Headache powder kills 
Henry Wehnker " (Fort Wayne, Ind.). " Medicine kills 
baby. Mrs. Holtgraver (19th and Cherokee Sts.) gave 
her baby a half teaspoonful of cough medicine. It died 
two hours later." 

If patent medicines do only harm, why is it that such 
glowing testimonials of them are published? None are so 
credulous as sufferers from disease. A consumptive in the 
first flush of hope over a new treatment always believes 
he has been benefited. He writes a letter praising it, and 
perhaps dies a few weeks afterwards. But the letter is 
used for years. Nostrum vendors publish many letters 
recommending their medicines and drugs as cures for 
diseases. Many testimonials are paid for; others are 
fictitious. Advertisements offer to send a valuable remedy 
free. Applicants are not answered, but their names are 
made into a " sucker " list and sold to patent medicine 
makers at ten dollars a thousand. Other advertisements 
offer free prescriptions, but charge for filling them. 

Note : — Preventing the Development of Nervousness in Family 
Life. — Older brothers and sisters owe a duty to the younger ones. 
Great mental steadiness and self-control will never be reached if the 
foundation for it is not laid in early childhood. To tease a child 
beyond its self-control, and to frighten so as to shock, are great wrongs, 



MENTAL HYGIENE 



175 



for they injure the nervous system and prepare the way for an un- 
stable mind. A nervous baby should not be played with. 

A child should not be too tenderly brought up. Protection from all 
strain and trial prevents hardening of the body and mind and growth 
in self-control. Children should have no coffee, tea, nor stimulant, 
but they should be required to eat all foods that are suitable to them. 
If a child does not learn to eat and digest all wholesome foods, he will 
become finical. This is the first step to dyspepsia, and dyspepsia is 
a certain cause of nervousness. A child who does not learn to take 
cold baths and to bear changes of temperature lightly may become 
one of those chronic grumblers about the weather. Childhood is the 
time to learn to bear pain and discomfort well. 

Playmates should be sought for a child when there are no play- 
mates of a suitable age in the family. To associate much with adults, 
to travel, to go to theaters and picture galleries before the age of 
twelve, deprives a child of its childishness and makes it nervous. 

If a child has learned that by crying and rage, or by pouting and 
sulking, it can gain what it desires, it is being given a bad start. It 
should be led to realize that it is making a stupid donkey of itself 
when it flies into a fury. The family should be indifferent to its 
temper, and not yield to requests until it becomes quiet and says 
" please." Thus the child will learn that the only way to get its 
wish is by controlling itself. 

To yield always to cravings for sympathy and to the desire of a 
child to be petted, may be an unkindness to it. Indecision, or hesi- 
tating before acting, is a nervous sign, and children showing it should 
be given work to do and be required to act promptly. There is little 
hope that a child's nervous system will escape damage if it is reared 
in a family in which uncontrolled nervous states are frequent. Next 
to heredity, example best assures the growth of steady nerves. 

Test Questions. — Why are nervous disorders increasing ? 
What is a sure sign of nervousness? What is the best remedy for 
nervousness? Are states of mind "catching"? What is said of 
cheerfulness? Of the habit of fretting? Compare the importance 
of thoughts and germs in their effects on public health. What is the 
chief use of the nervous system? Are mental disorders frequent? 
May they be prevented ? Why is it easiest to break bad habits and 
form good habits in childhood? What is race hygiene? What is 
said of the children of imbeciles? Who should not marry? What 
is said of precocious children? 

What is the demand for artificial stimulants a sign of? Name 



176 THE PEOPLES HEALTH 

natural stimulants and narcotics. What is a drug ? A food ? What 
is said of drug habits? Soft drinks? What kind of patent cures 
contain cocaine? Why are people caught with patent medicine 
frauds? What was a certain " rheumatic cure " made of? A " hair 
grower"? A "skin food"? An electric belt? What changes 
have been brought about by the pure food and drug law? What 
change in the law is needed ? Give some newspaper headlines. Ex- 
plain the glowing testimonials. 



CHAPTER XI 

A SANITARY HOME 




Courtesy of Henry Phipps Institute, Phila. 
Two home-made ice boxes (at left) and two home-made tireless cookers (at 
right) ready to cook rice and potatoes. 

Experiment i . Making a Fireless Cooker. — Put a five- or ten- 
pound lard bucket in a fifty-pound lard can or a candy bucket or a 
square box ; pack it under and around with finely cut hay or straw. 
Fasten a thick layer of straw to under side of. outside lid by a cloth 
tacked around edges of lid. A fireless cooker is used for food requiring 
long slow cooking without watching. It saves work and fuel. 

Experiment 2. To test a Fireless Cooker. — Fill the inner bucket 
with boiling water which should register 140 F. at the end of eight 
hours. Boil beans or grain in the smaller bucket for a few minutes on 
a stove, put on lid, and place immediately in the hay box or bucket, 
close outer lid, remove after a few hours and taste. 

N 177 



i 7 8 



THE PEOPLE'S HEALTH 



r\ 




\\ nT 




lr r 








ll w 



Courtesy of Wallup 
Bros., Waco. 

Iceless Cooler. 



Experiment 3. An Iceless Cooler. — This is made on the plan 
of a double-decked table (see figure). A large vessel containing 
water is placed on top. If made of galvanized iron, the upper 
deck has a water trough around its four sides. 
The supply of water slowly passes down a cloth 
that surrounds the entire cooler. The cloth (not 
shown in picture) must be wet before it is put 
on. As the water becomes vapor and goes into 
the air, it takes heat from the food and air in the 
cooler. 

Experiment 4. Proper Way to dust Furniture. 
— In the morning before school let pupils dust 
the desks with a damp cloth prepared as directed 
in this chapter.. 

Experiment 5. Study of House Furnishings. — 
Cut pictures from furniture catalogues and paste 
them in place on drawings of rooms, selecting and arranging them. 
Experiment 6. Do you breathe Dust ? — Darken the room and hold 
a window shade a little to one side to admit a beam of sunlight. Is 
the air dusty ? Or keep a shallow white dish containing water in the 
room for 24 hours. Does the bottom of the dish become coated ? 

The only sure foundation of a prosperous state is healthy, 
happy families, and no family can be healthy and happy 
that lives in an unsanitary home. 

The most sanitary home is not built directly on a noisy, 
dirty street. It is not built in a bare, cheerless spot, but 
is surrounded by green grass and protected from the glare 
of a summer sky by trees that shed their leaves in autumn. 
The planting is in clumps with open spaces between the 
masses of shrubbery or trees; the plants are not set in 
straight lines, and if there are flowers, too many colors are 
not jumbled together. 

The most pleasant farm homes are so located that trees 
or hills to the north or west break the cold winds; the 
barn is lower than the dwelling house, and the well is uphill 
from the barn, so that the water is not so likely to be 



A SAXITARY HOME 



179 



contaminated by seepage from it. Trees help to dry the 
ground and cool the air in summer. 

The cellar is so built as to be easily aired. Dirt, Dark- 
ness, Dampness, and Dust are the four demons of bad 
cellars. The concrete or cement for the cellar floor should 
be waterproofed as it is mixed. 

The kitchen is the most important room in a sanitary 
home. It is large enough and the walls and floor so finished 
as to be easily cleaned. The floor may be painted with a 
mixture of one pound of parafnne to a gallon of linseed oil. 
To save steps the stove, work table, cupboard, and sink 
are close together. The table cannot be cleaned perfectly 
unless it is covered with zinc. A zinc cover may be put 
on without soldering if the edges are carefully folded under 
at the corners and fastened beneath the table with nails. 

A kerosene or gas stove (under a hood) is necessary for 
hot weather and a fireless cooker is useful in all seasons 
(see Experiments 1 and 2). 

The kitchen of our grandmothers was large with plenty 
of windows. Many a girl leaves home and takes up la- 
borious unhealthy office work or typewriting rather than 
work in a little, dark, dirty, smelly, overheated kitchen. 
The broken-down health, the medical and drug bills, the 
o cook's waste and wages in most of such 

cases will more than balance the salary 
earned by typewriting or the cost of a 
convenient pleasant kitchen in which 
the daughter of the house might have 
had more suitable 
and womanly 
work at home. 
Buying and cook- 



GROUND LEVCU 




LEVEJ- 
3-PL.Y 

WATER PROOFING 
CONCRETE 



Waterproof cellar wall and floor (from Ogden's Rural Hygiene). 



i8o 



THE PEOPLES HEALTH 



ing healthful food require more intelligence than type- 
writing. 

Girls should study the science of foods at school; only 
the mother can train the daughter to love housekeeping and 
home making. Forty girls around a lady dressed like a 
nurse, • cooking dainties on little gas stoves may learn 




Courtesy of C. N. Millard, Esq. 



A Sanitary Kitchen. 



cookery scientifically, but they may not learn about food 
from the point of view of a home maker. But cookery 
has become a lost art with many women and they cannot 
train their daughters in it. The domestic science teacher 
supplies that defect. 

People must have good food to eat if the human race is to 
be saved from degenerating and becoming weak, both in 
mind and in body. The mother who, because of great 



A SAXITARY HOME 



T8l 



riches or dire poverty, has no time to train her daughters 
in kitchen arts, fails to inspire them with the ambition to 
be home makers. The mill girl or office girl marries ; the 
food she cooks swims in grease or is half raw, the beans and 
pease are so hard that they almost rattle in the pan, the 




Fr.mi Exhibit. Tuberculoids Congress, Wasfrinaton, 1908. 
COMPARE the walls, bedsteads, table, floor, chair, window curtain ol the room 
before and after hygienic furnishing. 



bread is in doughy hunks, and she is too ignorant of food 
values to choose nutritious food. 

The home should be furnished with regard to health. 
People may use as much soap and water as they like, 
but so long as they have thick carpets tacked down, cushions 
and portieres, lace curtains, bric-a-brac, and dust traps, 
heavy, immovable furniture, and many pictures, their home 
will not be clean. Bad taste and the love of having and 
hoarding will litter up the home with useless things and 
make housekeeping a burden. A house crowded with fur- 
nishings wears out the nerves as well as multiplies germs. 



182 THE PEOPLE'S HEALTH 

Good taste allows only a few choice ornaments. A hard- 
wood floor costs less than a carpet and is more durable. 
Stained or painted or bare floors with a rug or two are 
more sanitary than carpets. Outdoors there should be a 
" horse," or bar fastened to two posts, on which to hang 
the rugs for thorough beating. 

A single shade is enough for a window. Lace and net 
curtains are dust traps. No one should think of having 
them in living rooms. Simplicity is the mark of a refined 
taste. 

The walls of a home should be of soft tints. Walls of 
adjoining rooms are seen at one time while a door is open, 
and the walls of both rooms should be of colors that har- 
monize. 

In every clean and happy home the whole family co- 
operate; they have the habit of helpfulness that conquers 
selfishness ; each feels responsible for doing a share of the 
work and keeping a cheerful spirit. In such a home dirt, 
is prevented rather than cured ; muddy and dusty boots 
are cleaned at the door, instead of the dust of the street 
being beaten off in the house. Clothing and hats are 
taken to the back porch or yard to be dusted. Bits of 
paper and other trash are dropped into waste baskets or 
waste boxes, instead of upon the floor. Food waste is 
put into a garbage can out of doors, never in the cellar, 
and the garbage is burned when possible. The top is 
always kept on the can to prevent the breeding of flies. 
The well-fitting screens of the windows and doors are not 
left open. 

The rooms in a sanitary home are often sunned to pre- 
vent mustiness and mold, for a good housekeeper knows 
that sunshine is the cheapest and best disinfectant. Upon 



A SANITARY HOME 



I8 3 




Sterilizing by dropping in boiling 
water on the stove. 



retiring, the clothes are spread upon a chair to be aired. 

Upon rising, the bed clothes are thrown over the foot of 

the bed or a chair that the 

bed may be aired before it 

is made up. 

In such a home dishes 

and utensils used by the sick 

are kept separate. In case 

of contagious disease, the 

rugs (and curtains and car- 
pets, if there are any) are re- 
moved and a sheet is hung in 

front of the sick room door. 

A sanitary housekeeper fights dust as one of the greatest 

enemies of health and a frequent bearer of contagion. 

She will not allow the 
modern barbarism of 
dry dusting. She sees 
no especial good in 
moving the dust from 
the carpet to her 
lungs. Dust must not 
be simply moved, but 
removed. She prefers 
a damp mop for floor 
cleaning, but if a dry 
broom is used, she 
chooses a windy day, 
opens every door and 
window wide, sweeps 
with the wind, and 

A patient may be isolated at home. leaves the rooms Open 



SCARLET 
FEVER 




1 84 



THE PEOPLE'S HEALTH 



for one or two hours afterward. A good sweeping done 
in this way twice a week removes dirt and dust better 
than a daily sweeping that simply moves and stirs it. 
Walls may be dusted with a damp cloth or bag tied over 
a broom. Feather dusters and brooms are never used for 
cleaning living rooms in Europe. If a dust cloth is wrung 
out of water containing a little kerosene and allowed to dry 

for a while, it will hold 
enough oil to take up 
the dust without injur- 
ing the finest furniture. 
A sunny sitting room 
is more necessary than 
a sunny bed room. 
Snobbish people who 
have small houses give 
up half the house to a 
rarely used parlor, spare 
bed room and hall, and 
the family sleep in the 
smaller dark crowded 

Dusting with a damp cloth wrung out of water rooms where there is 

containing a little kerosene. 

danger of tuberculosis. 
In the chapter on pure air how many gallons of water 
did you learn must be vaporized daily to moisten the air 
of a small furnace-heated home? How is the air kept 
moist if a stove is used? The water pans of a furnace 
must be against or above the fire box, not down by the 
ash pit. With the air moist a less degree of heat is per- 
fectly comfortable. Dust will rise from the furnace if the 
damper in the smoke pipe cuts off the draft, or if the fresh- 
air inlet is closed and the cellar air is used — a most vicious 




A SAXITARY HOME 



18' 



custom followed by some with a false idea of economy. 
You have learned that the air in steam-heated houses can 
be kept moist in what way? 

The dusty, dry, unhealthful 
air of most houses has led to 
the admirable custom of using 
sleeping porches. " I don't 
mind telling the story on my- 
self," said a college president, 
" because it illustrates the new 
order of things. I always im- 
agined we slept with plenty of 
fresh air in my room and never 
gave the matter any thought. 
But my little boy got hold of 
a health bulletin on Fresh Air 
and decided that he wanted to 
sleep out. He worried us until 
we let him move his bed on 
the porch and after a few 
nights, he sang the praises of 
the open air so loudly that my 
wife decided to try it. She 
did and finally she was so en- 
thusiastic that I tried it myself. 
I've been sleeping out on the 
porch for six months now and 
I wouldn't change for worlds. 
I am in better health than I 
ever was and can do my work with much less effort. 
I've found out that the good Lord never meant for 
men to sleep indoors ! " — (Virginia Health Bulletin). 




Courtesy of Mr. E. R. Sanborn. 
Colonies of bacteria developed 
from dust lodged on plates during 
sweeping with a carpet sweeper 
(above), a broom and wet paper 
(middle), and a dry broom (lowest). 
Each spot shows a colony grown from 
a germ borne by a dust particle. 



186 THE PEOPLE'S HEALTH 

Housekeeping is a noble art and practicing the art 
makes sound and beautiful women. The physical-culture 
exercises of the beauty doctor go all right for two or three 
days, but because of boredom they come to nothing by 
the end of a week or month. The feeling of compulsion 
exhausts as much as the exercises recreate. Physical cul- 
ture in the form of intelligent housework is interesting, varied, 
and sure. The lady of the house notices that the woman 
who comes every week to shake the rugs and beat the 
carpets has well- shaped arms and a plump, graceful neck. 
The twisting movement of sweeping is an excellent exer- 
cise for keeping the abdomen within limit, the waist supple, 
and the shoulders poised instead of stooped or round. 
This is true if the sweeper stands erect with chest high, and 
most important of all, with the windows and doors open. 
Of course sweeping is bad if done with the back bent and 
the house closed. Turning a mattress or scrubbing 
clothes on a wash board is excellent for the trunk, making 
the abdomen firm and giving a fine curve to the back. If 
one only remembers to stand up straight, bend from the 
hips, and not at the waist or neck, and keep the windows 
open, any kind of housework is better for the looks than 
office work, mill work, or idleness. 

References. — Cornell Reading Course for Wives (Ithaca, N. Y.), 
No. i. Saving Steps; No. 3. Practical Housekeeping. Farmers' 
Bulletins (U. S. Dept. of Agriculture), No. 270. Modern Conveniences 
for the Farm and Home ; No. 345. Some Home Disinfectants. 

Note {For all the girls and some of the boys). — It is the daughter's 
place to help the mother with the little baby sister or brother. If 
there is no daughter, a manly son will gladly help his mother. The 
mother may be tired or have other work to do or be compelled to leave 
home for a time, and must trust the baby to a daughter or son. A 
bright girl or a business-like boy can be relied upon to carry out this 
trust in a safe way. A careless, lazy boy, or a giddy, silly girl, should 




Photographs by Miss May Belle Brooks for " The Housekeeper." 
Right and wrong way to sweep and to climb stairs. Bend at the hips, not at the 
shoulders. The broom should have a damp bag over it, or it may be dipped frequently 
in a near-by pail of water. 



A SANITARY HOME 189 

not be given this responsibility unless their love for the little one is so 
great as to arouse a keen sense of duty. 

Long experience has shown the need of the following safeguards : 

Keep the baby out of crowds. (Why?) Don't make it show off. 
Don't let any one kiss it on the mouth. 

Don't tease or fret the baby. Don't bounce it up and down. 

Don't let it suck its thumb or give it a pacifier to suck (unless 
you want to have an ugly brother or sister). 

Don't give it soothing sirup ; many babies f ' N*^ 
have been killed by it. L ^ ||||M a > ^ 

Don't take the baby into dusty places. A milk bottle easily 
Keep the flies off. Take the baby much into cleaned, 

the fresh air. 

Don't let the baby remain in a hot or closed-up room to sleep or 
even to take a nap. Open the window or take the baby to a porch, 
a park, or a garden, but keep it warm with clothing or coverings. 

Don't let the baby use a public drinking cup. Don't chew the 
baby's food for it. Don't put food into the baby's mouth that you 
have bitten. 

Feed it regularly and not too often. Don't feed it solid food before 
it has a few teeth. Don't feed it every time it cries, but try a drink 

of water ; especially in summer it must 
have plenty of water. Don't give it 
coffee, tea, or beer. If there is any 
doubt that the water is pure, use cool. 

bight wrong boiled water. 

Shoes for baby. Don't place it so that the sun will 

shine in its eyes. Keep it in the shade 
in very warm weather. Let it sleep as much as possible. 

The baby's clothing should not be so tight as to bind and be un- 
comfortable. It should be so held and carried that its soft bones, 
especially the backbone, are not deformed. Dropping it, or turning 
over the baby carriage, may deform or partly paralyze it for life. 

Test Questions. — Describe the situation of a well-placed home. 
Name the four demons of bad cellars. Describe a sanitary kitchen. 
Compare typewriting and cooking as work for girls. How is home 
making learned? What will follow if a race is poorly nourished? 
Give instances of bad cookery. 

What kind of a home cannot be kept clean ? What kinds of floors 
are sanitary? What is said of windows? Walls? How may the 





190 



THE PEOPLE'S HEALTH 



family cooperate to keep the home clean ? What is the cheapest and 
best disinfectant? What is to be done in case of a contagious dis- 
ease ? How is dust prevented by good housekeeping ? How may it 
be removed? How may a good house be misused by a snobbish 
family? How must the furnace be managed to prevent dryness and 
dust? What is said of sleeping porches? How may housekeeping 
contribute to the good looks of the housekeeper? Repeat a dozen 
"don'ts" and some things to do to keep your baby brother or sister 
sound and well. 

Illustrated Studies. I. It will be interesting and instructive for 
the pupils to draw on blackboard and explain the figures, pages : 95, 

96, 97, 98, IOO, IO3, I07, 112, 121, 122, 124, 127, 132, I33, I34, I36, 
139, I45, I46, l6l, 167, 169, 172, 179. 

II. Chap. V. From what sorts of nests come eggs of doubtful 
freshness? Describe the laboratory of a food expert. What are 
common adulterants of ice cream ? Describe a sanitary meat market. 
Which illustration suggests that the pure food law is merely an honest 
label law ? What does trichina look like ? What was effect of private 
dairy at Annapolis? Describe an unsanitary grocery. How is a 
fresh-air food box made? Why not buy shelled nuts? Chap. VI. 
Describe a rickety child. By blackboard sketch show composition 
of egg: also carrot, apple, banana, fig, walnut, chestnut, cow's milk, 
condensed milk. Sketch a grain of wheat to show its parts. Describe 
a stomach contraction. Chap. VII. How do well-bred people avoid 
droplet infection? Why is borrowing a pencil especially risky? 
How may disease be spread by readymade clothing? By drinking 
water ? What kind of towels are safest ? In sketches of nail wound 
infected by tetanus why was wound reopened to air (third sketch) ? 
Chap. VIII. How do wigglers escape from mosquito eggs? How 
does the tumbler, or bullhead, get air ? Describe fly's foot, larva, and 
pupa. Describe bat roost. Why are martin-boxes of public benefit? 
Explain garbage-can fly trap. Chap. IX. Is the boy or the bicycle, 
p. 154, to blame for the scorcher's position ? How is lateral curvature 
of spine treated? Explain chart of defective family. Compare fit 
and unfit bedroom furniture. How should dusting be done? Of 
what could you make a fireless cooker? Describe a sitting-out suit. 
Name six uncommon features in the Gary school. How ventilate 
room with a jacketed stove? 



CHAPTER XII 

SCHOOL SANITATION 

Experiment i. Temperature of the Schoolroom. — A daily record 
of temperature at 9.15 and 11 a.m. and 2 p.m. should be kept in 
a book by a committee of two pupils appointed monthly. It is well 
to find the temperature nearest to and farthest from the source of 
heat. Has your school a thermometer? Will it work? (The 




Keeping the Temperature Record. 

teacher will probably add to the scholarship credit of those who do 
this work well.) 

Experiment 2. Color Blindness. — Provide a number of yarns of 
the same and different tints. Let each pupil assort the yarns and 
match the tints. 

191 



JQ2 THE PEOPLE'S HEALTH 

Experiment 3. Test of Hearing. — Whisper to pupils standing 
equal distances away. Select those, if any, who cannot hear the 
whispers as far as most of the others. Test each ear by stopping up 
the other one. 

Experiment 4. Test Eyesight with standard types. 

Experiment 5. Astigmatism. — With flat end of crayon draw 8 
straight, even lines crossing at one point on the blackboard. Do any 
pupils report that a line in a certain direction is blurred? Inquire 
whether these pupils have frequent headaches (from eye strain). 

Experiment 6. Is each nostril clear for breathing? — Close one 
nostril by pressing with the finger ; close the mouth tight. There 
should be no difficulty in getting enough breath through one open 
nostril. Test the other nostril in the same way. 

Experiment 7. The Cause of Nasal Tones. — Let one pupil stand 
behind the others and read a paragraph, holding his nose until partly 
through. Or the teacher may read with his face and hand behind a 
large book. Pupils raise their hands at a change in the quality of 
the reader's voice. Does the experiment prove that a " nasal " tone 
comes through the nose ? How does catarrh cause a nasal tone ? 

Because a free state must have citizens with intelligent 
minds, it establishes public schools. But it needs citizens 
with sound bodies as well as sound minds. The school 
must protect and develop the bodies of young citizens 
in training while it is caring for their minds, if we are to 
have stanch citizens able to endure trial. 

Keeping children still for a long time is a risk to their 
health, and the risk is greater if there is imperfect ventila- 
tion and they breathe each other's breath. The school age 
includes the years when diseases are most readily caught 
from other persons, and the schoolroom is the most crowded 
spot in the community. 

Soon after a school was started among the Yuma Indians in 
Arizona, the Yuma chiefs found that the children were 
becoming less robust; they had colds and indigestion. 
This change was caused, not only by the want of exercise 



SCHOOL SANITATION 



x 93 



in roaming over the hills and by the crowded schoolroom, 
but also because the teachers furnished hats, shoes, stock- 
ings, and more clothes than were needed in that climate. 

It used to be the case that, to be a learned scholar, meant 
almost always to be flat-chested, nervous, delicate, if not 
a chronic invalid. These defects among scholars are not 
now so numerous, for schools are now provided with 




Courtesy of New York City Schools. 
Testing the Hearing of their right ears. Whispering gives a better test than a 
watch unless it is a stop watch. 

athletic fields, playgrounds, ventilation, gymnastics, bathing 
pools, and many aids to health. 

With an overcrowded course of study and an overcrowded 
room, many wrecked bodies will go out from the schoolroom 
into the world. Those crippled in health by going to school 
are still easy to find. Education obtained by damage 
to the body is hardly worth while. Bad schools destroy the 
' natural love of activity so that exercise is avoided all through 
life. Good schools preserve this love of activity. Arts 



194 



THE PEOPLE'S HEALTH 



and crafts form a healthful rest from books. If it is not 
encouraged, the natural instinct of children for such work 
will die out by the time they reach the high school. Work 
with the ringers instead of with the free arm, such as fine 
sewing or fine writing, puts a strain upon young nerves. 

Medical Inspection of schools, if efficient, raises the health 
standard. No child should have to suffer injury from 
going to school. A sound, clean child may suffer from 
contact with an unsound or unclean child. The school 
should protect the clean child by a change in the unclean or 
diseased child. With the help of the teacher and the school 
doctor, many may grow up to be sounder in body than if they 
had never attended school. 

Even in a compact city a school physician should not 
have more than 2000 pupils to inspect. The teacher may 
make the first tests for eyesight and hearing, and aid the 
physician in many ways. If a child has any defect, the 
school physician will find it out before it is too late for 
remedy. He can show the pupil and the parent how to re- 
move the condition that is causing the weakness, so that the 
child may outgrow it as his young body develops, and be 
sound when he has grown up. Defects found should be 
followed up until corrected. Because there are careless 
or ignorant parents who will not do this, a school nurse is 
employed in some schools to see that the doctor's orders 
are carried out. Otherwise, his careful search for defects 
will be useless. Of the 20,000,000 children in the schools of 
our land, it is estimated that 1,000,000 have a deformity 
such as flat foot or crooked spine, 1,000,000 have defective 
hearing, 5,000,000 ha*ve defective eyesight, 5,000,000 are 
undernourished, 6,000,000 have enlarged tonsils, and 
10,000,000 have defective teeth. Some children have more 




SCHOOL SANITATION 195 

than one of these defects ; half of them have none at 
all. 

A child with bad teeth often has little appetite, bad diges- 
tion, and suffers pain. Constant tilting of the head to 
help out a squint may lead to spinal curvature. Holding 
the work close to the eyes shows eye strain. The school 
nurse, physician, and teacher will watch 
for crooked spines and flat chests, decayed 
teeth, sore or weak eyes, headaches, colds 
(which they will consider a sign of neg- 
lected ventilation), mouth breathing, 
adenoids, dull hearing, consumption, weak S he gets no hard 
nerves, and, above all, infectious diseases. *"* so sh< : chews g T' 

J filth pockets in her 

Because they are helped in caring for aching teeth should be 

cleaned and filled. 

their health, the pupils will be absent less 
than before, their minds will be brighter, and they will 
finish the course earlier. This watchfulness about the 
health under successful medical inspection will impress its 
importance and educate pupils into the habit of looking after 
anything that harms the health — a habit that will last 
when school days are over. 

It is more sensible to pay a physician to keep you well and 
help you to grow strong many years before the strain has to 
be borne than to pay him for the often hopeless task of 
repairing a broken-down body. It is not only a cheaper 
and easier, but it is a much pleasanter, way. 

The Delicate Child. — In spite of all that can be done for 
the children, some of them will remain pale, undersized, 
languid, and unfit for the work of an ordinary school. 
Young and delicate children might well attend for only 
half-day sessions ; the other half of the day might well be 
spent on the playground. 



196 



THE PEOPLES HEALTH 



Some delicate children are tuberculous. It is not well to 
try to educate children who are in ill health in the ordinary 
school. They may be removed to a school in an open shed 




Sitting out Suit planned by Mr. Mann of New York Society for Prevention 
of Tuberculosis and made by Kenwood Mills, Albany. Detachable piece at bottom 
to prevent wear, hood for shoulders, snaps instead of buttons. Notice the windows. 



and taught more by means of things than of books. For ex- 
ample, arithmetic may be taught by means of counters, coins, 
weights, and measures. The children should lie down for 
one or two periods each day, and they should eat nourishing 
food. Since tuberculosis does not usually show itself for 



SCHOOL SANITATION 197 

from 2 to 10 years after infection, cases developing between 
20 and 30 years of age probably began during school days. 

Open-air and open-window schools show surprisingly good 
results in changing stupid children into bright ones and 
making strong ones of the weak. The children cease to be 
limp and listless ; the faces soon grow rosy and bright. It 
is wonderful how quickly the coughs, running noses, 
spitting, and swollen tonsils cease, and how free the children 
are from new infection unless they return to shut-in schools. 
A school should build up the health instead of breaking it 
down. Fresh-air schools do this, but the children must be 
equipped for it with very warm clothing. If the children are 
not equipped with special clothing, the temperature of the 
schoolroom is quite a different proposition. With the 
ordinary clothing, the schoolroom must be kept nearly 
closed in very cold weather, or the room cannot be made 
warm enough. 

The way to protect children from tuberculosis is to keep 
the windows open. The surroundings which cure a delicate or 
tuberculous child will still more effectively prevent such 
conditions. The time will come when the community will 
be logical enough to realize this. Prevention schools will 
make recovery schools unnecessary. In the Gulf States the 
window ventilation should be doubled in all but the severest 
weather by removing both sash from all the windows. 
The house may be protected from rain and closed by 
means of wooden shutters. 

With open-window schools, the children have to bring 
larger lunches, for, in these schools, even the sickliest 
child does not have to be coaxed to eat. In ordinary 
schools children sometimes cannot study well because they 
are hungry. The food at home is perhaps not of the 



198 the peoples health 

right kind, or they do not eat enough, or perhaps to 
chew well their teeth need attention. In Chicago 15,000 
children were found who, whether underfed or illfed, were 
backward in their studies because of undernourishment. 

If a poor widow has all her children taken away from 
work and placed in school that they may grow up to be 




A school athletic festival in Crotona Park, New York City. 

intelligent citizens, it is right for such children to have their 
lunches free. But there should not be free lunch for all. 
The London schools have tried the general free lunch and 
have given it up as undesirable. Lunches should be 
furnished at cost. If the basement is used for a lunch 
room, and there are no rents and no profits to pay, the 
lunches will be cheaper than could be bought elsewhere 
and will teach a lesson of economy in youth. Three cents 
will pay for a plate of good vegetable soup and two large 



TYPICAL SCHOOL 1VNCHEPNS phi^a 




Dakcd T>eans 6 Roll 5c 

Hay* pint of Mille&?uieo,straG'3c 

JWCCt Chocolate Ibur&uds Zc 

Total lOc 

Food value 700 Calorics 
TYPICAL PVPILS MENV 



3c 
3c 
3c 
5c 
3c 
Zc 
4c 
Ac 



CornCbo^cdcr d Roll 

Bee/ on Toajt 6 Roll 

Cocoa 6 Whipped Cream 

Milk, in pint bottles 

Millcin bal/ pint bottles 

Buttered Rol 

Ham iSandwieb 

Jam ^Sandwich 

Fruit Tapioca with WhippedGtam3c 

Ice Cream mixed in brick. 3 c 

Sliced Banana witbCrearo 3c 

Banana or Apple Z c 

Half Cantcl oupc 4c 

.5wect Chocolate l,3or3c 

Figs in para/5nc paper 2 c 

Dates ,/ ., .. Zc 




Cocoa ^-whipped qrxrarx> 3 c 
JE.90, sandwich 4c 

banana lc 

Four Dates lc 

Tbrce Coolcics 1 c 

Total lOc 

Food value 700 Calories 

ATYPICAL LVWCBEPST 

P VRCHA5ED ELSEWHERE 




Three Crulens 3 c 

Cup Of CO/^feC^itb cream escha r 3 c 

Total lOc 

Food value Z50 Calories 



EMMA fflCDUY iVPEMNTENDENT 



High School Luncheons, Philadelphia, are served to more than 500 teachers 
and 10,000 pupils of Central High School for Boys, Girls' High School, Wm. Penn, 
Southern Manual Training, West High Schools. 

Notice that the price is the same (10 c) but the luncheons bought at school give 
700 calories, the luncheon bought elsewhere gives only 250 calories. Another typical 
luncheon bought elsewhere of about same price and food value is : one cut of pie 
(5c), glass of milk (5 c). The above menus are used through the courtesy of Miss 
Emma Smedley, Supt. of Philadelphia High School Luncheons. 



200 



THE PEOPLE'S HEALTH 




Courtesy of Gary School Board. 
Plan of Basement and part of the grounds of a school in Gary, Indiana, a town 
which has become famous because its citizens decided that its schoolhouses and 
grounds should be the most complete and best appointed houses and grounds in town. 
On the school grounds there are also (not shown in above plan) walks, gardens, basket 
ball grounds, tennis courts, football and baseball fields. Such schools will not hinder 
but help the health of all that attend. 



SCHOOL SANITATION 201 

slices of bread. Some of the children may pay for their 
lunches by acting as waiters ; some public-spirited woman or 
woman's club will doubtless manage the lunch free of 
charge. A warm lunch is a better help to study than the 
cold lunch children would otherwise have. If children 
are allowed* to choose their lunches, they should not buy 
pies, buns, and sweet stuffs instead of simple food. The most 
foolish ones even prefer a penny's worth of candy and 
pickles from a pushcart to a warm, nourishing lunch. 

Country schools may have the best lunches. A committee 
of the oldest pupils and the teacher decides what each pupil 
is to bring for the following month, and if the girls are study- 
ing cookery, they cook a part of the lunch. In the rural 
schools of Oregon the girls prepare hot lunches on the 
school stove ; the dishes are kept in cupboards made by 
the boys. 

An empty stomach prevents a full mind. Under- 
nourishment shows itself in thin blood (anemia), pale- 
ness, swollen tonsils, readiness to catch disease, and in 
other ways. 

The Schoolroom should be properly constructed. If the 
law compels a child to go to school, it should not force him 
into an unhealthful schoolroom cared for by one of the most 
ignorant men in the community as janitor. The building 
should be in a well-drained place, and if in the country, 
should stand in at least one acre of ground. Loam is better 
for a location than clay. The inner walls and ceiling 
should be of some neutral tint that is easy on the eyes, 
such as gray, slate, buff, light blue, or green. Windows 
should reach almost to the ceiling, as the light from above is 
best for reading. Most of the light should come from the 
left side and none of it from the front. At least one fifth 



202 



THE PEOPLE'S HEALTH 



of the desks should be adjustable to accommodate unusually 
large or small pupils. 

All doors should open outward to prevent a crush in case 
of fire. If your schoolhouse is a large one, does it have fire 
drills? Is it provided with fire escapes? The door of 
the closets for wraps should not be left open ; s\ich closets 




Public School iS3, the Bronx, New York. How does its situation fulfill the 
conditions advised in the text ? 



should have a window or outside opening protected by 
slats. While the wraps are in the room, this opening should 
not be closed. 

A dark, foul storage basement for rubbish should not be 
tolerated, but a dry basement is a great advantage. It is 
useful as a playground in wet weather, or for a lunch 
room, gymnasium, or manual-training room. If the house is 
of wood without a basement, it should be built, except in 



SCHOOL SANITATION 



203 



cyclone regions, on pillars high enough to provide a wet- 
weather playground. 

The spread of infection by the school should be avoided 
with the greatest care. If the school board and teaching 
staff are not watchful, 

the school may easily be- -r^g * B§^ iMS^' 
come a center of infection. ^/^xMM l i 111 
School boards supervise 
inspection for weakness, 

chronic defects, and dis- -=g£lsRj^^ ^ y 
eases which do not spread ; 
boards of health usually 
have authority over in- 





A sanitary drinking fountain. 



fectious diseases ; but the school doctor, teacher, and nurse 
also keep a keen lookout for suspicious cases and promptly 
exclude them from school. Schoolroom dust carries germs. 
Indoor dust contains ten times as many 
germs as outdoor dust. A school in 
which contagious diseases appeared 
every year had none the year care was 
taken to avoid all dust in the school- 
house. Even when it does not carry 
infections, dust irritates and weakens. 
The signs of eruptive disease (scarlet 
fever, measles, diphtheria) must be 
carefully watched for. These signs 
are : flushed face, listlessness, vomiting, 
eruption on skin, red eyes, discharge 
from nose or eyes, cough, scratch- 
ing, sleepiness. Suspected cases should 
be promptly sent home. When cases are recovering, they 
should still be kept out of school for the sake of others 




Va. Health Bulletin. 
The School Dipper 
spreads many diseases. 



204 



THE PEOPLE'S HEALTH 



and for their own sake. Injury to eyesight, or other in- 
jury lasting for life, may be caused by a few days' study 
while the eyes are weak. Books used by pupils with 
contagious disease should be burned. If the school sup- 
plies books and they are not new, open them wide and 

stand them, in the sunshine for 
several hours the day they are 
given you. Sunshine, nature's 
gift, is the best and cheapest 
disinfectant. Each pupil should 
have his own drinking cup kept 
in his own desk. Old, rusty tin 
cups are unsafe. Pupils should 
not borrow from each other, but 
the teacher may have a smooth 
enamel drinking cup to be lent 
if unavoidable. It should be 
thoroughly rinsed before use. 
Dipping the cup into the water 
should not be allowed. If there 
is a public water supply, there 
should be a sanitary, or bubbling, 
drinking fountain; otherwise a 
covered tank or cooler, having a 
spring faucet or bubbling faucet, may be used. Water 
should not be wasted, and boys should not be allowed to 
try the stunt of shutting off the bubbling fountain with 
the mouth. By this uncleanly act the rim of the fountain 
is inclosed in the lips. 

Paper towels instead of cloth ones should be used. Each 
pupil should have his own pencil, and pencils should never 
be taken up and given out again. 




Courtesy of Gier & Dail Mfg. Co. 
A School Water Holder with 
a fountain faucet. 



SCHOOL SANITATION 



205 



Dust and Dry Air are a curse to the health in many 
schools. The schoolhouse should be built away from a main 
road. Grass, shrubbery, and trees will make it more health- 
ful. The playground, if not graveled, may be sprinkled in 
dry weather. Much dust will be prevented by wiping shoes 
and brushing clothes on entering. Marching in the halls 
with stamping feet raises much dust. Damp sawdust must 




Jacket Stove for Schoolroom. The fresh air led through conduit made of 
three planks comes in through grate under stone. Foul air leaves near floor and is 
drawn up through flue warmed by smokepipe of stove. 

be Used in sweeping, furniture wiped with a damp cloth, 
and the windows left open for several hours afterward. 
The walls should be swept down often. If turpentine and 
beeswax is rubbed into the flooring, the floor will not have 
to be scrubbed hard, but can be cleaned by merely wiping 
with a damp cloth. How often are your floors and black- 
boards cleaned? The erasers should be cleaned daily 
out of doors. The amount of chalk dust in the air of most 
schoolrooms is horrible. 

If the school is heated by a stove, the stove should stand 



206 THE PEOPLE'S HEALTH 

in a corner and should be jacketed. The cold air should 
come up through a fresh-air pipe under the stove. It will be 
kept close to the stove by the jacket until it is warmed. 
The smoke pipe passes through a brick flue. This flue is the 
foul air outlet and warms the air so that it rises through it. 
A large pan of water should be kept on the stove and filled 
daily. It is easier to heat the room comfortably when the 
air is moist and when there is some ventilation than when 
the air is foul and heavy with stale odors. Still air is harm- 
ful, and air of unchanging temperature is harmful. If a 
furnace is used, great care must be taken to moisten the air, 
either by driving it against a damp cloth or through a 
compartment in which jets of spray or steam are playing. 
The last plan is used with good results in several Chicago 
schools. The janitor's work should be constantly watched 
and tested by the teaching staff and medical inspector. A 
careless or untrustworthy man should be promptly dis- 
missed. It is unthinkable in a civilized community that to 
give a man a job because of politics, the health of the 
children should be endangered. 

If the children are to receive the full benefit of the school, 
and the taxpayers' money, instead of being wasted, is to be 
well used, the condition of both the pupil and the school- 
room must be kept right. 

An increase of io° above the right temperature of 68° F. 
cuts of one third of the working power of pupils. In Sep- 
tember, or whenever the weather is very warm, both 
sashes must be taken out of every window to prevent the 
pupils from sweltering, and so wasting their time. 

If health inspection by the medical officer is thoroughly 
made in the first grade, and the condition of each pupil 
recorded, it need not be generally repeated until the fifth 



SCHOOL SANITATION 207 

grade. If thoroughly done and followed up it will lead to 
material improvement of our future citizenship. Glad- 
stone said : " The strength of the nation hangs upon the 
health of its men and women." The foundation of that 
health must be laid in childhood. 

Medical inspectors watch out especially for obstructions 
in nose and throat and defective teeth. If a child has fresh 
air, with a clear nose and throat to breathe it through, 




Courtesy of Dtpl. of Child Hygiene, New York City. 
Girls with Adenoids. Notice the narrow nostrils, projecting lower lip, 
drooping upper eyelid. 

simple food, and a clean mouth to eat it with, he has the 
basis of health. Sometimes the tonsils, located in the upper 
part of the throat, become so swollen as to interfere with 
the passage of air from nose to lungs. Sometimes, what is 
called an adenoid growth forms in the same region and has 
the same effect. Either will cause mouth breathing, a 
serious evil. You would hardly think so, but another 
common cause of the mouth-breathing habit is that children 
with colds neglect to blow their noses and the nostrils 
become plugged with mucus. The child, being without a 



208 



THE PEOPLES HEALTH 



handkerchief or untrained in its use, allows the nose to 
stay stopped up and breathes through the mouth. When 
the nose becomes permanently stopped, the upper part of 
the throat behind the nose becomes a breeding place for 
germs (see Experiment 6). 

Adenoids are enlarged lymph glands. They are over- 
grown and become a poisonous festering mass because they 

have absorbed too many 
Eustachian tube germs from an unclean 
mouth and throat. When 
adenoids are removed, the 
child puts on flesh, sleeps 
better, the entire expres- 
sion changes, he becomes 
alert instead of listless, 
and the breath loses its 
bad odor. 

The mouth breather 
sleeps with his mouth 
open. Sleeping on the 
side and in a cold room may correct the habit. Closing 
the lips at night with strips of sticking plaster is sometimes 
effective. To give the child a chance to breathe right, 
adenoids must be removed if they exist. Mouth breathing 
causes deformity of chest, makes the ordinary mind dull 
or stupid, and bright minds less efficient. Notice in the 
pictures, the expression of face, the undeveloped nostrils, 
the mouth, the teeth. 

The nose warms and moistens the breath. Mouth 
breathing dries the throat, and the injured cells in its lining 
are less resistant to germs. Enlarged tonsils or adenoids 
may prevent the air entering the tubes which lead from the 




w 



The road the breath travels, showing where 
a gland-like spongy growth (adenoid) may 
block the road. 



SCHOOL SANITATION 209 

throat to the inner part of the ear. Then the circulation 
in the ear becomes weak and the hearing dull. Frequent 
colds may injure the hearing for life. If a child escapes 
ear disease until he is grown, his ears, barring accidents, 
are safe for life. 

Some children disobey because they have a weakness that 
prevents understanding. There is said to be a black sheep 
in every flock, but often it is only a weak sheep. If a 
child does not quite hear, does not quite see, cannot breathe 




Marked cases of adenoids. If you would not have adenoids, keep your mouth shut, 
sleep with open windows, eat simple food. Use your muscles. 

freely, it cannot pay attention. Scolding, punishing, 
bickering will not help. Fitting glasses, snipping the tonsils 
or adenoids, or changing to a front seat, may make the 
poor, puzzled, discouraged child happy and successful. 
Medical inspectors look also for signs of nervousness (see 
next page) in school children. A noisy schoolroom strains 
the nerves of teacher and pupil. All should talk in soft 
tones and as little as possible. Of 127 teachers that retired 
from the New York city schools in 1909, 46 stopped because 
of nervous breakdown. Quiet, considerate teachers and 
pupils have the best health. 

A few Pointed Questions. — Is your school room too light 
or too dark ? What can be done if there is a window in the 



2IO THE PEOPLE'S HEALTH 

front wall of the schoolroom ? If the room is very broad, 
are there windows on both sides? Is the schoolroom 
dusty? Are the outdoor closets sanitary? Are you ever 
without appetite and do you fail to eat breakfast? Do 
you drink coffee? Do you have toothache? Have you 
been to the dentist? Do you use a toothbrush? Is it a 
good one or a cheap one? Do you clean it well after use? 
Do you have earache ? To prevent catching diseases must 
you look out more for people or for things ? Is there usually 
too much heat in your schoolroom (see thermometer)? 
Are you in robust health? If not, what are you going to 
do to become so ? 

Note. — " Three thousand dollars of public money will be spent 
among the farmers of Buncombe county in improving their stock, 
their plants, and their soil while there is nothing being spent to guard 
or improve the health of their children." (Asheville Health Bulletin.) 
Buncombe is one of the most intelligent and progressive counties in 
the nation. The last part of above note is true of all counties that 
are without medical supervision of schools or practical study of 
hygiene. 

Note. Physical Examination of Children. — The teacher or the 
parent will find it useful to work carefully, through this list (adapted 
from Hoag) ; write yes or no after each question and encircle each 
answer which indicates a defect in the child examined. 

General: Is the child healthy in appearance? Color good? Body 
well developed ? Any apparent deformity ? Standing posture good ? 
Shoulders even? Normal walk? Heels on both shoes worn evenly ? 

Mental: Normally advanced in school for age ? Mentally alert, 
answers intelligently? Plays normally? 

Nervous Condition: Good tempered? Freedom from tantrums, 
blues , and spells ? Good control of muscles ? Spasmodic movements ? 
Bite nails? Stammering? Irritable? Very timid, easily embar- 
rassed? Cruel? Fits? Headaches? 

Teeth: Clean? Sound? Regular? FiUings? Six-year molars 
sound? Use toothbrush? Gums sound? Upper teeth protrude? 
(See chapter on Food.) 




Testing the Eyesight. 




Courtesy Mass. Charitable Ear and Eye Infirmary. 
Reading without glasses and after glasses are fitted. 




Tooth Brush Drill. 




Children at flat desks. Notice the heads bent down. The left-handed bend head 
and spine to right, the right-handed bend to left because edge of*desk is higher than 
elbow hanging naturally. Reading and writing are unnatural and wrong desks 
should not add to the strain. Courtesy of Geo. H. HeUmuller, M.D. 



SCHOOL SANITATION 



213 




Nose and Throat: Breathe with mouth closed? Open? Nasal 

discharge? Nasal voice? Nostrils close together? Good chin? 

Usually free from sore throat? Hard palate broad? 

Ears: Hearing good? Must questions be repeated? Fairly 

attentive ? Fairly bright in 
appearance ? Expressive 

voice? Spell fairly well? 
Frequent earache ? Hear a 
whisper as far as other 
children? Discharges from 
ear? 

Eyes : Eyes straight ? 
Chronic headache? Easily 
fatigued by study? Squint 
or frown? Leans over desk 
or holds head to one side? 
Eyes red or with discharge ? 
Eyelids healthy ? Writing 
on blackboard easily read? 
Have the eyes been tested 
separately with test type? 
Skin : Red circular patches 

(ring worm) ? Spots with crusts and pus (impetigo) ? Red, scratched 

lines and spots on hands, arms, between fingers (itch) ? 
Test Questions. — Why have public schools been established ? 

How may a school become the source of as much harm as good 

to the state? State facts 

which show that schools 

may be a source of danger 

to a people's vigor. What 

good habit of childhood 

does the school tend to 

destroy? How may the 

school care for the body? 

What is the best way to 

use a physician ? What are 

the duties of the school 

doctor and nurse ? What defects are common among school children ? 

Why is medical care of pupils a saving to the public purse ? 

What may be done for the delicate child ? What is the effect of open- 
air schools upon the pupils? Compare the merits of prevention 



Dr. Heitmuller's adjustable desk for pre- 
venting flat chest, crooked spine, and weak 
eyesight. 




Movable Desk on Table. It is better to 
prevent defects than to find them. 



214 THE PEOPLE'S HEALTH 

schools and recovery schools? What is the connection between 
backward children and undernourishment? What plans are sug- 
gested for school lunches in town? In country? Describe the 
proper location for a school. What is said of its walls ? Lighting ? 
Desks? Doors? Cloakrooms? Basement? Fire protection? 
Discuss school and the spread of infection. How do we know that 
school dust is a danger? What are the signs of eruptive diseases? 
What precautions are to be preserved in regard to books ? Drinking 
water ? Towels ? In what ways may dust be prevented ? How is a 
schoolroom to be ventilated that is heated by a jacketed stove ? How 
may the schoolroom air be kept moist enough? Who should super- 
vise the janitor? How does temperature affect working power? 
For what defects do medical inspectors watch most carefully ? What 
is the cause of adenoid growth ? What are its consequences ? What 
results when it is removed? Why is mouth breathing injurious? 
What is often a cure for disobedience? What are the (i) general, 
(2) mental, (3) nervous signs of defects? What are the signs of de- 
fects of (1) teeth, (2) nose and throat, (3) ears, (4) eyes, (5) skin? 




Courtesy of Surgeon General Torney, U. S. Army. 

Measures for Public Health at the Isthmus of Panama. 

Sewer Aqueduct of a sewer passing along the hillside at Culebra, Canal Zone. 
A house for workmen on the canal with the veranda screened is seen at the right. 
Canal Zone is a distant part of our country, but it is reached by wireless telegraph. 




A Dirty Alley. 



Courtesy of Washington State Board of Health. 
What kind of people do you think live here ? 



T- I 


j— — 




3 


•—. — . ' 




T : 


ti 


I 


! . It 
11 




h li 


— 


-£. 




mm 


MIII M**ilg-B'' 



A Clean Alley. 



Courtesy of Washington State Board of Health. 
What kind of people do you think live here ? 



216 



CHAPTER XIII 

THE PUBLIC HEALTH DEPARTMENT 

Observational Studies, i. Water Supply. — Two pupils may be 
appointed to study and report upon the public or private water supply 
of the community. 

2. Sewerage. — Two pupils may report upon the disposal of sewage. 

3. Duties of Local Health Officers. — A committee may report 
the names and duties of officers having control of sanitation. 

4. Local Sanitary Survey. — To complete the local sanitary survey, 
after reports on the above have been read, the following may be 
studied : The Disposal of Refuse ; The Public Market ; Bakeries ; 
Parks and Playgrounds ; The Lighting System ; Breeding Places of 
Disease-carrying Insects. Some may take a trip to see where the 
milk comes from. 

The health of one cannot be perfectly guarded without 
guarding the health of all. We are interested not only in 
the health of our own nation, but in the world's health. 
About two hundred years ago the plague, or black death, 
killed one fourth of the people of Europe. It has been 
lurking in the interior of China ever since and it reappeared 
in civilized countries in 1893. Cholera is always in India, 
ready to be carried over the world. But since the discovery 
of germs as the source of infection, and the enforcement of 
sanitary rules, our dread of these diseases is greatly lessened. 

Long before man knew how infectious diseases spread, 
the value of public health measures was understood. Moses 
was a wise sanitarian, as the Bible shows. 

If, like the Athenians, we " revere and obey the laws 
and do our best to arouse like reverence in those who are 

217 



2l8 THE PEOPLE'S HEALTH 

prone to set them at naught" (page i), we can do much to 
enforce sanitary rules and prevent the spread of disease. 
Each can aid in the great movement for better health con- 
ditions which has accomplished so much in the last fifty 
years. A citizen now runs only one half the risk of dying 
of tuberculosis that his grandfather ran. The death rate, 
or number of deaths in a year among iooo people, has 
decreased about one half in fifty years. 

If you would be prepared to " uphold the ideals of 
our country, both alone and with many," do not forget 
that sanitary knowledge is as important as sanitary laws, 
and make a careful study of the conditions of public health 
and the ways of preventing disease not only as they are 
presented to you in this book, but wherever the opportunity 
is offered. You will not follow health laws blindly, but 
intelligently. When you learn the underlying principles, 
you can be a better citizen. 

When you are old enough to vote, remember that health 
is one of the ideals to uphold, " both alone and with many," 
and that health officers appointed because of political 
influence are usually of little good. Only trained and in- 
telligent men should be placed on guard to ward off disease 
and protect the people's health. Health officers should 
not be politicians, but scientists ; that is, they should know 
how to base their actions on the study of facts. 

Society seeks to protect itself against the ignorant, careless 
citizens and prevent them from becoming carriers of 
disease and sources of danger to all. Each must first take 
care of his own home ; do not object to your neighbor's 
manure heap which breeds flies if there is a rain barrel at 
your home that breeds mosquitoes. 

We used to think that the health of each person was his 



THE PUBLIC HEALTH DEPARTMENT 



219 



own business. Now we recognize that conditions producing 
disease in one are liable to produce it in others, and that 
one case of illness may endanger a whole city. You may 
not escape the carelessness of your neighbor. No family 
has the right to live in filth. A man is a bad citizen if 
he merely keeps himself worried, nervous, or surly; for, 




Tuberculosis cases must be reported to health office. This is the Tuberculosis 
Hospital at Washington. Notice the highest story is open all round. The grass and 
trees prevent dust. Washington has the most picturesque situation of all the 
world's capitals — forests, high hills, deep vales, waterfalls, rapids, cliffs, islands, 
rivers and bays are within the city or in sight of it. 

as you learned in studying mental hygiene, his bad state of 
mind is liable to spread to others. Even in the country 
where people live on separate farms, all the contagious 
diseases will spread, either through the school or in some 
other way, if there is a loose handling of local health 
problems. 

In the city the physician visits the slum, the lawyers 



2 20 THE PEOPLES HEALTH 

go to the courtroom where vermin are brought in by the 
vicious, the servant spends her half-holiday in a house 
crowded with the ignorant or careless, the newspaper is 
sold by a boy from a disease-infected home, the clothes 
meet and mix in the laundry with the clothes of all sorts of 
people, the trunk of a respectable traveler is stored with 
trunks containing roaches and bedbugs, the book from the 
public library has just served to pass away the time for some 
one recovering from illness, and was returned without a 
sunning or airing, men, women, and children crowd each 
other and breathe each other's breath in street cars, post 
offices, schools, picture shows, and churches. Without a 
Board of Health the 



Cost of New York 
State Capitol 
$25,000,000 



Annual Cost of New York 
State Government 
about $32,000,000 



Yearly losses caused by consumption in 

New York State 

$70,000,000 



hygienic standard for 
the town will be fixed 
by the most worthless 
and stupid. 

Some people who do 
not take care of them- 
selves say they do not have time to" think of self : but if 
they haven't time to think of self, they should take time to 
think of others. To weaken one's own body so that a disease 
which you may spread to others is caught as soon as a 
disease germ touches you, is like providing inflammable 
material where there are matches ; one may cause a fire, 
the other an epidemic, and health is more valuable than 
property. It is easier to prevent a fire than, after it has 
started, to put it out before it burns down the house. The 
community can organize and cooperate to fight disease. 
Thus only can it hope to ward off disease. Since the 
interests of the citizens are the same, protection can best 
be secured by all working together. Health officers, 



THE PUBLIC HEALTH DEPARTMENT 



221 



physicians, school inspectors, teachers, nurses and all 
good citizens, cooperate for public health. 

The town, like the average man, is willing to pay well 
for stopping disease, but is not so ready to pay for preven- 
tion. It usually takes some disastrous outbreak of disease 

Massachusetts State Board of Health 

TOTAL ANNUAL APPROPRIATIONS 

• 200.000' 
I9a ■ 











7 


7 ± 


i7 


-t 


4 


\y 


2 


4^ 


-^ J?- 


7 N""^ 


\ Z 


> —■ -T 



1900 
.YEAR 



170. - 
160. ■■ 
150. - 
140 - 
UO. - 
120. - 
MO. • 
100 - 
30 - 
80. - 
70. - 
60. - 
50. - 



Chart showing how a state which is very careful for the health of its citizens has 
increased the yearly money for its board of health, in 24 years, from $58,000 to 
8162,000. Compare with amounts in chart on page 220. 



to stimulate a town to pay for a good water supply or 
sewerage. j 

No other money spent brings so much return as the 
taxes paid for good government. For it we get schools, 
good roads, courts, and protection for property and health. 
Those who rob, destroy material wealth ; those who scatter 
disease, destroy what is more valuable than property, 
health, and life itself. Many people in the world have little 
respect for other people's rights, even when they know 



2 22 THE PEOPLE'S HEALTH 

them ; an efficient health department enforces respect for 
other people's rights. 

In matters of sanitation, the rights of the individual 
must give way to the general welfare. Those who pledge 
themselves " never to desert a suffering comrade " will be 
still more eager to avoid doing anything to bring suffering 
upon their comrades. They will be willing to submit to 
exact inspection and weary quarantines, and willingly 
obey every regulation for the prevention of disease; for 
are not life and health " sacred things, for which we will 
fight both alone and with many " ? 

A good citizen does not neglect personal hygiene, for he 
knows they make a serious mistake who rely on laws and 
officers to do anything for them which they can better 
do themselves. But he has a right to demand from his city 
government freedom from flies and mosquitoes, pure drink- 
ing water, a proper disposal of sewage and waste, clean 
streets, rules against the building of insanitary houses, 
freedom from infection for his children at school, that all 
infectious diseases shall be promptly known, and that 
quarantine be strictly enforced, and that tainted or 
adulterated foods and impure milk be kept off the market. 

Vital Statistics. — For the future welfare of the citizens, 
accurate records of diseases, deaths, births, and marriages 
should be kept. Records of births and marriages are 
necessary in proving citizenship, and claims to property 
on the death of relations. Even if the weather and roads 
are bad, and the office some distance away, the health 
officer should be given the information the law requires. 
The blanks should be carefully filled out. Only by such 
records can it be known to health officers and law makers 
what are the sanitary defects and what is needed to guard 



THE PUBLIC HEALTH DEPARTS EXT 



223 



the health of the people. When the death rates from the 
several diseases are accurately known, their cause and pre- 
vention can be intelligently sought. 

Every one can do a little for the public health. He can 
refrain from spitting on the sidewalk. He can help keep 
the streets clean by placing fruit skins, paper, and rubbish 
in the trash boxes fastened on posts for the purpose. He 



ST. PAUL 


214.744 


2558 


11.9 


MINNEAPOLIS 


301.408 


3739 


12.4 


MILWAUKEE 


373.457 


5205 


13.9 


LOS ANGELES 


319.198 


4538 


14:2 


CLEVELAND 


560.663 


8047 


14.3 


ROCHESTER 


218.149 


321S 


14.7 


SAN FRANCISCO 


416.912 


6319 


15.1 


ST. LOUIS 


687.029 


10888 


15.S 


KANSAS CITY 


248.381 


3966 


15.9 


DETROIT 


465.766 


7452 


15.9 


INDIANAPOLIS 


233.650 


3824 


16.3 


BUFFALO 


423.715 


6940 


16.3 


JERSEY CITY 


267.779 


4401 


16.4 


DENVER 


213.381 


3533 


16.5 


NEWARK 


347.469 


5784 


16.6 


LOUISVILLE 


223.928 


3756 


16.7 


BOSTON 


670.583 


11562 


17.2 


CINCINNATI 


363.591 


6319 


17.3 


PROVIDENCE 


224.326 


3980 


17.7 


PITTSBURG 


533.905 


9603 


17.9 


BALTIMORE 


558.485 


10753 


19.2 


WASHINGTON. D. C 


331.069 


6511 


19.6 


NEW ORLEANS 


339.075 


7250 


21.3 



Annual death rate per 1000 of the chief cities of the U. S. Seattle, Washington, 
has the lowest, and Portland, Oregon, next ; but they are not included in this table 
which is based on U .S. census of 1010. The negro death rate in Washington, Balti- 
more, and Xew Orleans is about twice the white rate and raises the average. 

can warn any storekeeper that violates the pure food law, 
and report him if he breaks it a second time. 

Sometimes, in order to save themselves trouble or expense, 
selfish people try to hinder the enforcement of health laws 
made solely for public protection. But the courts protect 
the public welfare and force obedience to law. " The 
safety of the people is the supreme law " has been a rule since 
Roman times. " So use your property as to injure no one " 
is another established rule of law. The law holds a man 



224 



THE PEOPLE'S HEALTH 



responsible whose factory pollutes a stream, or who main- 
tains a slaughter house with a bad odor. 

The staff of the health department should be men of such 
character that the people's sense of fair play will never be 
outraged by reports of any one using improper influence 
with an inspector to escape a fine for maintaining an unclean 
store or market, selling adulterated or impure milk, or 



* Scarlet Fever. 
Isolation and disinfection 



neglected in 366 
outbreaks, av'ge— 

Cases. J Deaths. 



enforced, in 361 
outbreaks, av'ge — 

Cases. I Deaths. 



t 



Diphtheria. 

Isolation and disinfection 

enforced in 252 
outbreaks, av'ge— 
Cases. I Deaths. 



neglected in 317 
outbreaks, av'ge— 
Cases. I Deaths. 







E3 



Effect of isolation and disinfection on Scarlet Fever and Diphtheria in Michigan 
(Report of State Board of Health). 

to have a quarantine raised because it interferes with his 
business. A man who gets drunk or borrows money from 
the dairyman whose milk he inspects, should be promptly 
turned out of office. The health physician should be 
selected for character and ability, not because he is too 
young or too old to practice medicine. The salary for his 
services to the public should be large enough to support 
him without his practicing. 



THE PUBLIC HEALTH DEPARTMENT 



225 



A Quarantine, when necessary, is set up by the chief 
health officer. You can no more have an infectious disease 
unless the germs of the disease reach you than a farmer can 
grow a crop of wheat or cotton without sowing seeds in 
the soil. 

It is criminal to keep a case of scarlet fever or other 
dangerous disease concealed instead of reporting it at once 
to the health officer. If 
the first case of infectious 
disease that appears is 
promptly dealt with, a pes- 
tilence, with its untold evil 
and suffering, may be pre- 
vented, and people will not 
be liable to carry the infec- 
tion to distant places and 
cause other epidemics. Epi- 
demic is from the Greek, 
and means "upon the 
people." 

House quarantine is called 
isolation. If only one person 
in a family has an infectious 
disease, the patient is iso- 
lated in one room, preferably an upper room. The house is 
itself isolated and placarded, and only the physician and 
nurse are allowed to come and go. House quarantine is 
sometimes modified so that the wage earner of the family, 
if he never comes in contact with the patient, can go out 
to his work. The placard is not removed until the disease 
is over and the house has been disinfected. " Dogs, cats, 
and other pets should be thoroughly washed with soap in 
Q 




Va. Health Bulletin. 



Careful inspection at school prevents 
epidemics of diphtheria, measles, etc. 



226 



THE PEOPLE'S HEALTH 



a tub of hot water containing 5 per cent solution of carbolic 
acid" (Iowa Health Bulletin). 

Inland quarantine between towns and states is enforced 
by armed guards. Maritime quarantine is easier ; the ship 



BiiOL 

h 


* 1 



Courtesy of Dr. Arthur L. Murray. 
Sterilizing Plant at the Quarantine Station, Washington. Articles are placed in the 
wire cage, rolled into the steel chamber, shut up, and treated with steam. 

is stopped at the entrance of a port and anchored unless it 
proves a clean bill of health. 

Periods of detention for those who have been exposed to 
infection: Smallpox, 12 days; Measles, 10 days; Scarlet 
fever, 3 days; Diphtheria, 3 days ; Cholera, 19 days; Ty- 
phoid fever, 14 days. If there is no new case among those 
detained for the period of quarantine, they are released. 
The law requires that infectious cases be reported as soon 
as known by physician, parent, teacher, householder, or 



THE PUBLIC HEALTH DEPARTMENT 227 

neighbor. Pestilence will return to do its terrible work so 
long as people are lawless and unfair to their neighbors and 
community by failing to report such cases. As sanitation 
is perfected, quarantines will become rarer and less neces- 
sary. The living human capital, or wealth, of the nation 
is estimated at a money value of five times all its natural 
resources. This is the calculation of Professor Irving Fisher 
of Yale, who years ago was given up to die of consumption, 
but who recovered through the fresh-air cure. A statesman 
who would strengthen and enrich a nation must do every- 
thing possible to strengthen the health of the people. 

An old farmer said: " I wanted to send my boy to college, 
but my apple crop failed and I couldn't raise the money. I 
wrote the government, and they sent directions for spraying 
my trees and a man to show me the method. The next fall 
I harvested the biggest crop of apples I ever had. I sold 
them and sent my boy to college. I never was so happy 
in my life, sir, but when he had been there a month he took 
typhoid fever and died. They found the drinking water 
at the school was polluted with filth, and a public danger. 
The State saved my orchard, but the State let my boy be 
killed. Does the State take more pains to save the lives of 
fruit trees than of its citizens ? ' ' (Virginia Health Bulletin.) 

Sanitation, together with fewer wars, has lengthened the 
average human life to 42 years, — about twice what it was in 
other ages. The awakening of the community conscience 
in regard to the poisoning of infants by impure milk, and 
the improvement in the milk supply, has saved many babies. 
This and the prevention of epidemics have helped to increase 
the average length of life. 

The longer life at the present day is a triumph of public, 
preventive measures, and is not the result of stronger, health- 



228 



THE PEOPLES HEALTH 



ier citizens. On the contrary, it is in spite of ever weaken- 
ing bodies, as is shown by the fact that while pestilence and 
infectious diseases have decreased, those diseases have in- 
creased which are the result of bad habits and wrong living. 
Acute diseases, caused by germs, are being mastered by 
science and kept down by efforts for the public health. 
Chronic weakness and disease, such as mental disorders, 
weak nerves, idiocy, epilepsy, dyspepsia, diabetes, and 
Bright's disease and diseases of the heart are twice as fre- 
quent as they were a long time ago. They increase every 



***** Indicating INCREASE In Deaths from Degenerative Diseases and DECREASE Cwm Tuberculosis 




Courtesy of Metropolitan Life Insurance Co. 
Showing that the death rate per 10,000, from degeneration, or chronic diseases, in- 
creased from 18 to 38 — more than double — in 30 years. Do we mean to go on in 
this way or to wake up to personal hygiene as we have to public hygiene ? 

year. The great blessings of public hygiene should not 
cause us to overlook this great need of personal hygiene. Sen- 
sible people acknowledge the need of plain food, pure water, 
right living, and of knowing how to take care of the body if 
they expect to accomplish anything in the world. Yet 
most people injure their health by slow and continued 
poisoning from unnecessary food, bad air, and inactive 
muscles. Seldom do they work or move with enough vigor 
to cause deep indrawing of the breath, send the blood bound- 
ing to enlarge the blood vessels of the skin and freshen it 
up, renew the blood in the gorged blood vessels of the liver, 
and wash out the poisons stored up in the cells, because of 
inactive, indoor life. 



THE PUBLIC HEALTH DEPARTMENT 220 

We need to have more faith in the body and its perfection, 
but to remember there is a limit to its endurance. We 
should be grateful for its power to make its own medicine, 
to repair its elastic covering and broken bones, for the 
watchful white warriors in the blood, the wonderful little 
chimney sweeps in the windpipe sufficient for those who 




Courtesy of Dr. E. F. McCampbell. 
Laboratory of the Ohio Board of Health, Columbus. Microscopic search for germs of 
typhoid, rabies, tuberculosis. 

live in decent air, the glands which make oil and all needful 
things, the tears to wash the eyes, the ear wax, which like 
sticky fly paper, protects the ear from insects, the slippery 
fluid which keeps the joints in order, and. the many other 
wonders of the body. The body tends constantly to 
health and only gives way after long, outrageous abuse or 
foolish strain. The man who boasts that he has an iron 
constitution usually has a muddled head. 



230 THE PEOPLES HEALTH 

Many can learn how to prevent ill health and grow old 
without losing enjoyment of life ; few that wait until the 
evil day of sickness comes, can learn how to live so as to 
make the body grow strong again. It is easier to learn 
how to keep well when we are well, how to follow the laws 
of health, than to unravel the tangle of disease. 

We should learn how to attend to personal hygiene for 
a public reason. The reason is this : The bacteria of 
the same disease, for example, typhoid, have differing races 
or strains of different degrees of virulence, so that one out- 
break of the disease may be in a mild form, another a very 
severe one. A person with a vile body seems to make the 
germs more virulent if they sojourn in his body. They 
flourish and learn to multiply more rapidly, and when they 
leave him they have become a stronger menace to the com- 
munity. When we so plan our lives as to make our bodies 
strong and efficient, we are doing the very things that will 
enable us to resist disease, and remain safe citizens. 

Things that the local or state health departments will 
probably do for the community. It will make chemical 
and microscopic examination of doubtful drinking water; 
test for adulterated or impure milk ; give or sell diphtheria 
antitoxin ; send vaccine for typhoid, smallpox, and rabies ; 
examine the brains of dogs suspected of rabies; examine 
the sputum for tubercle bacilli ; test cattle for tuberculosis ; 
examine for the eggs of hookworm and other parasites ; 
examine specimens of blood for the malarial parasite ; ex- 
amine cultures from the nose and throat for diphtheria 
bacilli ; establish quarantine ; fumigate and disinfect 
houses and contents after quarantine is raised. 

Test Questions. — Show how the health of all peoples is connected. 
Who was the first great sanitarian known? What has sanitation 



THE PL B LIC HEALTH DEPARTMEXT 



2 3I 



achieved with tuberculosis ? The general death rate ? What kind of 
health officers are usually of little use? Why is one's own health 
not entirely his own concern? Give some of the dangers of contagion 
to which citizens and travelers are exposed? Name things that we 
have a right to expect of the health department. Give the reasons 
for keeping vital statistics. Xame two very old rules of law that 
apply to public health measures. What kind of men should the staff 
of the health department consist of ? Tell of the need and the kinds of 
quarantine. What is an important duty of statesmen? 

Tell of the old farmer's apple trees and his son. What is the aver- 
age length of human life? What has chiefly helped to lengthen it? 
Has personal health increased or decreased with the average length 
of life? Why? Xame some of the wonders of the body. State a 
public reason for keeping the body sound. Name things that a local 
or state health officer will do. How is fumigation to be done ? 

Note. To Fumigate a Room. — i. Close all openings. 2. Paste 
strips around the windows, doors, and on keyholes. 3. Open all 
drawers ; disarrange all bed covers. 4. Sprinkle everything thoroughly. 
5. Soak sheets in formalin and hang them on ropes in the room. 6. Use 
a pint of formalin for every 10 square feet of floor space. 7. Leave 
room closed for 8 hours. 8. Open the windows, and air for a day. 
9. Scour all woodwork with soap and water. 10. Boil all washable 
goods, and sun everything for a day or more. 




Preparing to fumigate a room. It would be better to stand the books in the sun 
with leaves open or to burn them. A metal vessel on bricks is used for the disinfec- 
tant. Sulphur may be burned to kill insects, but formalin is used for killing germs. 



CHAPTER XIV 

HEALTH AND CITY LIFE 

The recent growth of large cities has been a severe blow to 
national health. Cities, as now built, tend to cause a 
decay of the race. Urban families are small, and the chil- 
dren are often weak and delicate. People from the country 
are constantly moving to the city. This raises the stand- 





Pa 


PiOi 




Pi - j| 




y^B^9 




ite^Jf-Mj-.^H^-. 1 



Courtesy of the Hebrew Alliance. 
Children playing on a roof, New York City. 

ard of health in the city, if they do not come from villages 
where the conditions which lead to weakness and waste of 
human, life are no better than in cities. 

A city could be so built as to be as healthful as the coun- 
try ; each possesses an advantage that the other lacks. 

The average child of 7 years, brought up in one of the 
new garden cities of England is three inches taller than one 

232 




Mulberry Bend, New York Citv, as it was. 




Mulberry Bend as it 




234 



HEALTH AND CITY LIFE 



235 



of the same age living in a densely built English city. At 
14 years old the difference was found to be five inches, and 
the difference in weight was 30 pounds. 




Courtesy of X. Y. Ass'nfor Improving Condition of Poor. 
Ax Open-stair Building. Half of this building contains a home hospital (for 
curing consumptives at home) planned by Jno. A. Kingsbury. Compare windows 
and balconies of the two portions. There is a playground on roof. 



In laying out cities, the early settlers of America, although 
they had the whole continent before them, built the oldest 
portions of our Atlantic coast cities almost as crowded as 
the cities in the crowded Old Country. The oldest streets 
of such cities are narrow, dangerous, bare, dusty, and unfit 



236 



THE PEOPLES HEALTH 



for man or beast ; no tree can grow in them. Skyscrapers 
on broad streets reduce them to narrow chasms, sunless 
except for an hour each day. Lower Broadway, New York, 
is thus being made into a narrow, dark street. 

Streets where people dwell should have a parking, with trees 
in the center and a strip of parking with a row of trees be- 
tween footway and driveway. In planning a garden city, 




One Floor of an Open-stair House. Each flat has its own public entrance, and 
the whole house can be shut off from the street by closing the court. 



native trees are left untouched wherever possible. Not 
over two houses are built to an acre ; there are many parks 
and playgrounds. The handsome public buildings are 
placed at the ends or turns of streets, or facing squares and 
open spaces. The streets are laid out to follow the easy 
slopes of the hills. Factories are built in a space set apart 



HEALTH AXD CITY LIFE 237 

for them, so that their noise and dust are removed from the 
homes, and they are so placed that the prevailing winds will 
blow the smoke and odors away from the city. 

One who lives in a city cannot possibly keep well by his 
own efforts, however carefully he lives. Every citizen's 
health is dependent upon people he doesn't know and may 
never have heard of. These people are studying and plan- 
ning day and night to keep disease away from him. By 
isolating disease they often stop it before it gets fairly 
started. The supplies of water, milk, meat, and other 
foods must be guarded. If the sewers should be neglected 
for 24 hours, the citizens would be dying by thousands. 
The house must be guarded against bad plumbing ; the air 
must be guarded from pollution. 

If a city is to be kept clean, pavements must be often 
washed. Dust blows up more easily from a pavement 
than from a country road. Spittle does not sink into it as 
it would into the ground, but dries in the dust, and the dust 
is whisked into the faces of passers-by. Street dust kills 
not only people, but trees. 

It is a pity for families with children to live in flats and 
other kinds of tenement houses, especially if there is no 
park or playground near. The " apartment " is often 
smaller and more cramped than a tenement flat. Hundreds 
of children playing in the streets are killed or injured every 
year, and thousands die or grow weak and sickly because 
they do not have enough outdoor life. Lodgers in flats 
have to take a vacation in the country every summer 
to preserve their health, but this is not enough for 
growing children. Tenements and apartment houses 
should always have playgrounds and gardens on the roof. 
" A boy without a playground foretells a man without a 



238 THE PEOPLE'S HEALTH 

job." A city with many places of recreation means that 
in the future many barkeepers will be without jobs. 

A dark house is an unsanitary house. Sunshine bleaches 
the carpets and wall paper ; the lack of it bleaches the face. 
A " cliff dweller " selecting an apartment in a house should 
demand : at least five hours of sunshine or clear daylight 
in every room, a playground for the children, fresh air un- 
tainted by sewers or factory, walls and floors deadened to 
noise, no unnecessary noise in street or house, freedom 
from vermin, whether insects, rats or mice. 

The stuffy, unclean air and want of privacy in tenements 
with indoor stairways may be avoided by open-stair buildings. 
Then no public hallways are needed, and the entry to each 
flat is private. Many such healthful tenements are now 
being built in place of the old dismal houses built around 
a vent shaft. 

The worst slums in our cities are inhabited by Chinamen 
and other poor foreigners who disregard hygiene even more 
than the native-born. Some negroes are especially neg- 
lectful of the laws of hygiene and eat cheap and often 
decayed food. In cities both North and South, the quarter 
where poor negroes live is often low and flat with unpaved 
streets, imperfect plumbing, and drainage, and becomes a 
breeding place for disease, affecting the health of the 
whole community. Women go from the quarter directly 
into kitchens all over the town. There is a danger to all 
in neglecting the health of any. 

Quiet is as necessary for sound nerves as light and air. 
City noises wear out many people and cause them to break 
down. The noise of street cars is added to the endless 
clatter of trains on elevated tracks and wagons on rough 
pavements. The trolley cars could run smoothly except 















tejV 


1 1 


1 






f idW/ 


:l WJ 


I 
















- - . 




yfc 





Seven-cent Lodging House, New York City. These men are out of work. 
There is plenty of healthful work in the country. 



7 mm 




Baxter Street, New York, as it was. The drains extended only a few feet from 
these houses and did not reach the sewer. 



HEALTH AXD CITY LIFE 



241 



at curves, and would make hardly any noise if the rails were 
separated from the pavement by strips of wood, as is done 
in Frankfort and some other German cities. Street cars 
are now being built so large that they jar the earth as they 
pass. 

Many of these noises last until late at night ; and then 
at three o'clock in the morning the milkman, baker, and 



■Wk' : 


— - 1 






— -i.'jiL,L, 


•mmm 



Dupont Circle, Washington, D.C. Dust is prevented by promptly removing 
droppings from horses. Notice the beautiful trees. Have you such trees in your 
town ? If not, are you planting trees ? The author enjoys these trees every day, and 
hopes you have as fine ones at your home or will plant them. 

errand boys begin their noisy rounds. Many noises could 
easily be stopped. There should be a fine for running a 
street car with a flat wheel. Inmates of apartment houses 
who play the piano after ten o'clock at night, and are noisy 
at other times, should be given notice to leave. Many 
noisy people would take the- hint and correct their bad 
manners, and the others would move to houses where all 
are noisy. Houses should be so arranged that the heat can 
be turned on and off in each room, so that those who do not 



242 



THE PEOPLE'S HEALTH 



wish great heat need not have it. Many Americans are 
fond of overheated rooms, and throat and nervous troubles 
are common because of it. 

Because strangers in cities are suspicious of each other, 
cities are very lonely places. Suspicion and loneliness, 
moreover, are bad for the nerves. 

Only streets with smooth pavements can be kept really 
clean. Several methods of street cleaning are in use : the 
rotary broom creates nuisances in the streets by raising dust 




Alley Gang, Washington, D.C., sprinkler, rotary broom, brushes, cart. 



or scattering mud when the sprinkling is not just right; 
the flushing method of washing the streets, using hand-force 
pumps on the tank wagons and applying the water through 
nozzles with considerable pressure, is more sanitary. It 
creates a fine spray in the air, however, and the rotary 
rubber squeegee which scrubs the streets just behind a row 
of nozzles is preferable to any machine except a vacuum 
cleaner. Street cars are often shamefully dirty and dusty. 
Their floors should be washed at least once a day. Some 
conductors seem to think the ventilators are merely for 
ornament, and others are much more prompt in closing 






HEALTH AND CITY LIFE 



243 



than in opening them. What did you learn about the 
dust of cities in the chapter on Pure Air? 

Carrying food through dirty, dusty streets is a risk to the 
health of those who eat it. Bread is sometimes handled 
like kindling wood. The baker's wagon is kept in a dusty 
stable at night, yet is never scrubbed or cleaned, and is 
unprotected from dust in front and rear. The hand that 
holds the reins and pats the horse carries the bread or holds 




Courtesy of Dr. W. C. Woodward. 

Three Squeegees scrubbing New Jersey Ave., Washington, D.C. The National 
Capital is noted for its broad avenues, fine shade trees, and clean streets. Every 
citizen considers travelers as guests, and is glad to help them find their way and see 
the city. 



the loaves against an unclean coat. Delivery men should 
wear driving gloves and remove them before handling food. 
The bread should be wrapped at the bakery. Fruit should 
be peeled, cooked, or washed before it is eaten, if it has been 
exposed on carts or stalls. Do not eat street dirt. 

Every town should have a public market place, and every 
city a number of market places, and the farmers should be 
encouraged to come with fresh food and sell directly to 
consumers. This food will be fresher and cheaper than it 



244 THE PEOPLES HEALTH 

will be if taxes and restrictions force it to pass through the 
hands of middlemen. Food can be more thoroughly in- 
spected in markets than if it is scattered over the city in 
stores. The fewer the towns and cities with such market 
places, the higher will be the cost of living. 

Test, Questions. — How has the growth of cities affected national 
health ? Compare a child in an English garden city with a child in a 
densely built English city. Describe how a healthful city should be 
laid out. Show how one's health in cities depends largely upon 
others. What are the disadvantages of family life in tenements and 
apartment houses? What is said of playgrounds? What points 
should a city " cliff dweller " require when selecting a flat? 

What are the advantages of open stairs? What class of people 
often inhabit slums ? What are often the needs of a neighborhood in 
which poor negroes live? What is said of city noises? Describe 
methods of street cleaning. (Study photos also.) What is said of 
cleanliness of food brought through the streets? What are the ad- 
vantages of a public market ? 









CHAPTER XV 

RURAL SANITATION 

Supplementary Study. — As this chapter is begun, the teacher may 
issue to the pupils the following bulletins obtained from the Depart- 
ment of Agriculture at Washington ; also state bulletins or books on 
farm life, and require reports or summaries on stated days : Farmers' 
Bulletins. Xo. 155. How Insects Affect Health in Rural Districts. — 
270. Modern Conveniences for the Farm and Home. — 345, Some Home 
Disinfectants. — 444. Remedies and Prevention against Mosquitoes. 
— 450. Some Facts about Malaria. — 459, House Flies. — 473. 
Tuberculosis. — 478. How to Prevent Typhoid Fever. Bureau of 
Entomology. Bulletin 78, Economic Loss in U. S. from Insect Carriers 
of Disease. — The Farmstead, by I. P. Roberts (The Macmillan Co.). — 
Rural Hygiene, by H. X. Ogden (The Macmillan Co.). — Household 
Hygiene, by S. Maria Elliott. 

In studying public health in the previous chapters we 
have already studied many questions of rural hygiene from 
several points of view. Let us now see what we remember 
on that subject : What did you learn about clean milk, 
sanitary dairies, clean barns, healthy cows ? What disease 
of cows is passed on to babies in dairy milk ? How is mire 
and muck in the stable lot prevented? (Situation, slope, 
gravel, ditches, drains.) What diseases are transmitted 
in milk ? 

Why is typhoid more easily passed on to others in the 
country than in the city? Where are patent medicines 
most largely used? Why? Where is it easiest to have 
healthy surroundings? Why is the country man less de- 
pendent on public hygiene than the city man ? (Chapter I.) 

-MS 



246 THE PEOPLE'S HEALTH 

What advantage does the most badly constructed country 
house have over the city house? What advantages may 
farmers have in the food supply ? What is the best way for 
distant farmers and consumers in towns and cities to deal 
with each other ? (Chapter VI.) Why is it against the in- 
terests of most town people to put restrictions on the use 
of the market place by neighboring farmers ? How may a 
farmer's wife test eggs before sending them to market? 




Courtesy of Mr. G. A. Briefer. 
A Class of Boys spraying fruit trees. 

What advantages in health has the farmer who neither buys 
nor sells much food, but grows what he needs at home? 
How many profits will he save ? 

Is man by nature an indoor or outdoor animal ? In the 
chapter on Pure Water what did you learn were the dangers 
of shallow wells? How is a safe well provided? How do 
the useful bacteria near the surface of the ground protect 
the well? About how deep do they work? 

What insect carriers of disease are more abundant in 
country than in town ? How may town and country each 
affect the health of the other? How may damming the 



RURAL SAM TAT I OX 



2 47 



waters of a creek prove a curse to a countryside ? What 
insects breed in stables? 

Which of the natural stimulants and narcotics mentioned 
in the chapter on Mental Hygiene are in the farmer's reach ? 
Has he as much reason as the town dweller to imagine he 
needs artificial stimulants? What great advantages has 
the country for nervous people ? What suggestion was 
made for lunches in the country school ? Does a coun- 




From Bricker's Teaching of Agriculture in the High School. 
Boys judging Swine. (Agricultural High School, Douglas, Ga.) 

try school spread infection? Does public opinion allow 
visiting in your community in a home where there is 
contagious disease? Are the other children of a family 
promptly excluded from school when one child has a con- 
tagious disease? 

Do the state and national health offices work for rural 
as well as urban health and protection ? Does the county 
health office work for both ? Has the city health office any 
power in the country? Have you selected a community, 
or district, health office? 

Many young people go from the farm to the city. A 



248 



THE PEOPLE'S HEALTH 



young man tires of the farm and moves to the city, hoping 
to have an easier job and to earn more money; but too 
often the ruddy, vigorous farmer boy changes into a fat 
and waddling or pale, stooping worker at a desk, more 
dependent financially than before. 

Farm life is often lonesome, but it need not be so. The 
best rest and refreshment for a tired plowboy is a game 

of baseball, and every 
neighborhood should 
have a ball ground 
for a game at the end 
of each week. This 
will develop the boy's 
social nature as well 
as prevent his losing 
interest in lonesome 
work. The school- 
house should be a 
social center. For 
political and business 
meetings it may re- 
place the courthouse, 
saloon, and loafer's 
corner. Sociables and 
play parties at the 
schoolhouse once a 
month, with occasional dramatic and musical entertain- 
ments by home talent, will combine with other forms of 
recreation to make life interesting. 

Food in the country is the freshest and purest. The 
air is not contaminated by the smoke nuisance or a plague 
of dust. The farmer's life in the sunshine and pure air, 




Iowa Health Bulletin. 
Criminal Ignorance. Washing the clothes of 
a typhoid patient within two feet of a well. Be- 
sides the seepage, her hands on the rope may in- 
fect the well. 



RURAL SANITATION 



249 



far from crowded places, insures escape from germ diseases 
for those who are cleanly and careful. If a country baby 
is bottle-fed, it gets the freshest of milk. 

But there are some families on farms who are so careless 
that they are more sickly than the average family in a 
crowded city. Consumption, to which pure air is such a 




Courtesy of Indiana Board 0/ Health, Hon. J. M. Hurty, Sec'y. 
Typical rural tuberculosis home (Crawford Co., Ind.) : windows few, walls tight. 

foe, ought to be a disease of the city only, yet there is much 
tuberculosis in some rural districts among families who try 
to close the house like a sealed box and overheat it with 
stoves. Others work constantly and allow the children no 
recreation, or will not protect their wells, and suffer from 
typhoid as much as those who live in the worst city slums. 
Dr. Hurty, speaking of a farm family indifferent to 
health, says : " They neglect the bathtub, and overwork 
the frying pan. Their bread is overfermented and under- 



250 THE PEOPLES HEALTH 

baked. They eat too much of smoked, pickled, and salted 
pork. There is as little fruit and vegetables as if they 
had no space for an orchard or garden. If the appetite 
for delicious fried chicken and seven kinds of jelly palls, 
they arouse it with a large dose of pickles. These things, 
with polluted drinking water, explain why such a farmer 




Courtesy of Indiana Board of Health. 
A typhoid well, Gibson Co., Ind., that caused many cases and 10 deaths. 

is a large buyer of patent medicines. This farmer is sure 
to locate his cesspool so that the vault contents will drain 
into his well." Luckily such farmers are uncommon. 

What did you learn in the chapter on Insect Carriers that 
applies to the farm? 

Many farm wells get infected from hands and mouths 
that touch the well bucket. To touch the rim of a well 
bucket with your hand is the same as putting your hand 
into the water that others are to drink. A self-tilting well 



RURAL SANITATION 



251 



bucket should be used, and the well platform should be 
water-tight. 

A farmhouse that lacks water pipes and water pressure 
need not lack a shower bath in summer; a space in the 
back yard four by six feet may be walled in with planks, 
and a flower sprinkler filled with water may be used to 
spray one's own body until it is cool, clean, and refreshed 
after a hard day's labor in the field. Instead of the 
sprinkler a can with many small holes punched in the 
bottom may be used. 

An ideal farm is easy to have, if it is arranged on the 
right plan. The dwelling house is near the top of the hill 
with trees near enough 
to break the wind in 
winter and keep off the 
glare of summer, and 
yet not so close as to 
prevent sunshine from 
falling on the house. 
The house is not so 
built as to be hot in 
summer and cold in 
winter, but with the 
opposite plan. Neither 
barn nor outdoor closet is south of the dwelling where the 
wind would take odors into the house. The well is above 
the house, and the barns and stable yard below it, at least 
100 feet distant. The kitchen and bedrooms for the family 
are the most comfortable rooms in the house. The porches 
are wide enough for family gathering or for open-air 
sleepers. 

No stagnant water is allowed in the neighborhood, and 




Courtesy of Indiana Board of Health. 

Two left out of a family of four. Cause, a 

typhoid well. Such results will be impossible 

when an aroused public conscience will demand 

that all wells be made safe and kept safe. 



252 



THE PEOPLE'S HEALTH 



the pest of mosquitoes does not exist. There are few flies, 
for manure sheds and outdoor closets are screened and made 
fly tight. The stable yard is well ditched or drained, and 
manure is not allowed to accumulate, but is scattered on 

the field on a certain 
day each week, to pre- 
vent flies from breed- 
ing; for the housefly 
is most dangerous in 
rural communities, 
because there the dis- 
posal of infected 
household wastes is 
most difficult. 

If there is a cistern, 
it is elevated so that for convenience the water may be 
drawn at the open window or from the edge of the porch. 
Carefully fitted screens protect the kitchen and dining room, 




Manure Bin with fly-tight lid and on skids, to 
be drawn by horse once a week and manure spread 
on fields. 




Courtesy of Mississippi Board of Health. 
The fly hatches in the manure pile, lunches in the closet, and dines in the dwelling. 

if not the rest of the house. If there is not a septic tank 
(page 256) for all sewage, the slop pail and garbage can are 
kept constantly covered. The members of the household 



RURAL SANITATION 253 

work for shorter hours, but more efficiently, have time for 
recreation, and life is not drudgery. 

Such a farm does not poison the city by sending impure 
milk and butter, and the summer visitor does not have to 
fight insects and boil the drinking water. The young 
people of this family do not migrate to the city, for they 
can see that the cramped life of towns is not as wholesome 
as pleasant country life, and that wage slavery is often the 
lot of the city dweller. 

Hookworm Disease is very common in warm countries. 
During the past few years it has been found in nearly all 
of the warm countries of the world. All 
persons who live in such countries should * C \ t 
know about the disease in order that they 

Hookworm, male 

may protect themselves against it and be and female, natural 
cured if they should chance to have it. 

The disease is caused by a tiny worm, called the hook- 
worm, which gets into the body and lives in the intestine 
or bowel. The worm is about as big as ordinary cotton 
sewing thread and about half an inch long. Its mouth is 
provided with hooks by means of which it fastens itself to 
the soft lining of the intestine, and there it lives and feeds 
on the soft lining of the wall and on the blood of the person 
who harbors it. The worms get into the body through the skin. 
When persons who have hookworm disease pollute the soil, the 
tiny eggs hatch, and from them come very small undeveloped 
worms, or embryos. These live in the top soil and in a few 
days are ready to enter a human body. When the sun is 
hot, they burrow down out of sight, but on cloudy days 
and in the early morning when the dew is on the ground 
they live in the very topmost layers of the soil. When a 
person with bare feet walks over such soil, the little hook- 



254 



THE PEOPLE'S HEALTH 



worm embryos catch hold of the skin and burrow into it 
until they reach the blood. They are then carried into the 
heart and lungs, and go on from there to the stomach and 
bowels. 

As they burrow into the skin they make sores which are 
called dew sores or dew itch, sometimes ground itch or toe 
itch. This is one of the first signs of the disease. Treat 
ground itch promptly. Never go with bare feet through 




Courtesy of Hon. Wickliffe Rose, Sec'y Rockefeller Sanitary Commission. 

At left, home of a worm-sick family in iqio. They hardly worked at all, and no 
child had gone to school for three generations. At right, home of same family in 1912, 
built by the family 14 months after cure. Children now go to school and family are 
hard workers. 

muddy places,, or even on damp ground, or before the sun 
has dried the dew. Always be examined for hookworms 
within three months after having the ground itch. 

What are the Signs of the Disease? — If a person has only 
a few worms living inside him, he may show very few signs 
of the disease. He will probably have slight indigestion, feel 
weak and disinclined to work. Many persons who have 
the disease get the reputation of being very lazy. If per- 
sons have many of the worms, the signs are much worse. 
They are pale and weak, suffer from headache, indigestion, 
shortness of breath, and fluttering of the heart. Some of 
them have dropsy, a condition in which the limbs swell up 



RURAL SAX I TAT I OX 



2 55 



and the face and other parts of the body become swollen 
and puffy. The hair is dry and rough and the skin rough 
and of the color of tallow. 

The Cure of the Disease. — It is fortunate that the dis- 
ease is easy to cure ; a drug called thymol, when properly 
given, will cure the disease in almost every case in a very 
short time. 

The disease may be prevented by wearing good tight 
shoes all the time l and by not letting polluted soil come 




Typical pained expression about the eyes of two Porto Rican Hookworm 
Victims. U. S. health officers cured thousands of worm-sick people on the island. 
(Cost, 60 c. each.) 

into contact with the skin. The best way is to prevent 
the pollution of the soil by the use of the sanitary outdoor 
closet so that the eggs cannot get on the ground to develop. 
The eggs cannot develop in the body, and if we prevent 
them from developing outside the body the disease cannot 
spread. Two things are necessary to eradicate hookworm 
from a community: (1) Stop soil pollution; (2) Cure 

1 Hookworm experts in the U. S. teach this, yet Dr. Ashford found that 
more than half of a company of soldiers in Porto Rico became infected on 
one march although they were wearing stout army shoes. 



256 



THE PEOPLE'S HEALTH 



every sufferer from the disease. Such a task is the work of 
years. 

How the Disease is Recognized. — The disease can some- 
times be recognized by looking at the patient, but the sure 
way is to examine the discharge of the patient under the 
microscope to see if it contains the eggs of the hookworm. 
The State Board of Health will make this examination 




Courtesy of Indiana Board of Health. 
The contents of a septic tank are purified by standing, as fermentation destroys all 
disease germs and liquefies the solids, and the contents are siphoned off and spread 
upon the field. 

free and will send you a mailing case for sending a speci- 
men if you will write them and ask for it. 

Country Slums. — Although one half of the people of the 
United States live in the country, more efforts have been 
made J or sanitation in cities than in the country. This is 
because the crowded condition of cities compels attention 
to public health. There are slums in the country as well 
as in the city, and they, like city slums, are breeding places 
of infection dangerous to the whole people. Country- 



RURAL SANITATION 



257 



omattcaiL 



sides where ignorant, shiftless inhabitants settle and neglect 
the conditions of health form the rural slums. 

Intelligent rural neighborhoods give to our country its 
most vigorous citizens, but rural 
slums supply a greater proportion 
of the inmates of insane asylums 
than any other class of people ex- 
cept the very rich in cities. A 
health survey of a certain western 
county showed the farm homes 
within it were worse ventilated 
than the homes of the largest city 
in the same state, and consump- 
tion was as 
frequent in this • «_ rf ==s ^ 
county as in 
the largest city. 
An examina- 
tion of the 
stock of the 
country stores 
in villages in 

. The L. R. S. Sanitary Closet (compare with septic tank, 

ma tar I at alS- p. 255). The vault consists of two barrels connected by a pipe 

trid's of fr^n dif or a cement trough ( cost & 12 ) w * tn a partition. The liquefying 

J ' J tank is filled with water to level of connecting pipe. The fecal 

fe rent States mat ter ferments in the water and liquefies, disease germs being 

destroyed by the fermentation. Additions of excreta raise 
Showed that the level of the liquid, and the excess flows into the effluent 
two fifth f tan k- Because of evaporation it requires emptying only about 

LWO nitns 01 once in two years After disinfecting effluent tank, contents 
the shelf room may De s iP none d off for fertilizing. An old closet may be 

changed to a Sanitary Closet if roof admits of raising floor. 

were taken up 

with patent medicines. Attempts to keep in health by the 
aid of patent medicines give a fair measure of the lack of 
sensible efforts toward the same purpose. 





<£ t <7ue)'u/r)4 tanj^ 



2 5 8 



THE PEOPLE'S HEALTH 




In the country the annual death rate for each 100,000 
people is as follows for several diseases : Tuberculosis, 136 ; 
intestinal diseases, 121; bronchitis and grip, 90; pneu- 
monia, 83 ; diphtheria, 1 7 ; whooping 
cough, 12; scarlet fever, 8; measles, 8. 
The country death rate is increased and 
the city death rate is lowered because 
so many sound, healthy people move 
from the country to the city. 

Because so little community of in- 
terest is felt in the country, greater personal responsibility 
rests upon the head of each household. Public sanitary 
control is hindered by the isolation and independent men- 
tal habits of the farmer. In 
country slums, a farmer some- 
times even gets angry because his 
child with the whooping cough 
is excluded from school. Progress 
is best gained by appeals to the 
intelligence of educated citizens, 
and by the spread of education. 

Official supervision of public 
health is needed everywhere. 
Sanitary districts should not be 
laid out according to settlement 
unless the population is sparse, 
but according to watersheds and 
drainage. The people of the dis- 
tricts may elect district health 

officers who pledge themselves to carry out the orders of 
the county health officer. ' The district officers in conven- 
tion choose for county health officer one who has passed 




Home Water Cooler. Cis- 
tern water is more healthful than 
water from dug wells. To cool 
it fill a large metal bucket or tin 
vessel in evening. Tie around 
it a wet cotton cloth which dips 
into a pan of water. A wooden 
cover should be kept on the 
bucket during the day. 



RURAL SANITATION 259 

the examination required by the State Board of Health, 
or one who has a diploma in public health or preventive 
medicine. 

Xote. — The citizens of each community should hold an annual 
meeting not only to elect a local guardian of health but to assign 
other duties which should be divided in an orderly community. 
No community can prosper where the citizens live in selfish loneliness, 
jealous of each other's success. Scientific farming by individuals, and 
cooperation and combination by the whole community are essential 
to health and happiness in rural life. Farming is more suitable 
for the basis of ideal living than for quick profits. Fairs at the county 
town drain and weaken the country, but a neighborhood fair helps 
and stimulates. There should be quarterly and monthly market 
days in each country district. 

According to the " Coleman Plan," at the annual community meet- 
ing, the following cooperative workers may be elected: 1. Barber. 
(Unlike the town barber, his chair and tools will not bring the risk of 
infection by persons from the whole town and county.) 2. Blacksmith. 
3. Butcher. (See Farmers' Bulletin No. 183. The farmers will take 
animals in turn to him for butchering and will not have to eat ran- 
cid salt meat.) 4. Buyer and seller. (He will soon become expert 
and will get discounts for his neighbors by buying in large quantities.) 
5. Cobbler. 6. Carpenter and lumberman. 7. Carrier, to distribute 
meat, bread, and supplies, and collect things to be sold. 8. Health 
guardian (against infection, breeding of flies and mosquitoes). 
9. Freighter (to town once a week) . 10. Referee, a wise and just-minded 
man. 11. Road foreman. 12. Sports manager, who will plan a good 
ball ground, swimming hole, recreation grove, and arrange holiday 
celebrations, match games, athletic meets. 13. Junker, to buy and 
sell second-hand articles. 14. Seedsman, to develop and save the best 
seed. 15. Chairman of meetings at Neighborhood Center (the school- 
house?). 16. Storekeeper. 17. Teacher. 18. Tinker, for tinware, 
sewing machines, clocks, etc. 19. Trustees for school. Of course all 
remain farmers. The storekeeper, for example, opens the store for 
only one hour each day. 

The community work of the women may be divided as follows : 
1. Baker. 2. Butter and cheese maker. 3. Manager girls' canning 
club. 4. Manager of school or neighborhood fair. 5. Merrymaker, to 
arrange parties, play picnics, and merrymakings. 6. Postmistress. 



260 THE PEOPLE'S HEALTH 

7. Reading club manager. 8. Referee. 9. Song and glee leader. 
10. Seamstress and tailor. 11. Teacher. 12. Trained nurse. She, 
like many of the other workers, should miss no opDortunity for study 
and training in her special work. 

Test 'Questions. — What are the advantages of farm life to health ? 
Why do young men go from the farm to the city ? What is a country 
slum? Why is public sanitation in the country difficult? What is 
said of tuberculosis in the country? Give the shortcomings of an 
ignorant farmer as described by a state health officer. Describe dif- 
ferent ways in which members of a farmer's family may cooperate for 
healthy, happy living. Describe the location and arrangement of a 
healthy farm home. What is said of visiting a family where there is 
a contagious disease ? 

To what is the hookworm disease due ? Describe the worm. What 
are the symptoms of the disease ? How is the disease spread ? Give 
the life history of the hookworm from the time the egg is laid until 
the egg is laid again. Can the disease be cured? Which is better, 
prevention or cure? How can it be prevented? What can school 
children do to help eradicate the disease? 

What proportion of the people live in the country ? Why is more 
attention paid to sanitation in cities? What causes rural slums? 
The greatest proportion of insanity comes from what two sources? 
What is said of patent medicines in the country? How is a home- 
made shower bath provided in summer? Give the death rates of 
several diseases in the country? What is said of personal responsi- 
bility and health in the country ? What plan is suggested for organ- 
izing the public health service ? Give an outline of the author's plan 
for organizing a country community (see note). 






CHAPTER XVI 

INDUSTRIAL HYGIENE 



j 


19 


$ &$pffif. 






^^fUmimm 




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Courtesy of National Child Labor Committee. 
Girl Spinning Cotton. In this mill children of widows may legally work until 
9 p.m. Other children quit at 8 p.m. The roaring, buzzing, and jerky noise of the 
machinery is deafening and nerve racking. 

Man spends more of his time sitting down or standing 
still than he has ever done before. When he moves from 
place to place, he usually rides. With the use of sulky 
plows and reapers even farming tends to become a seden- 
tary, or sitting, occupation. 

Man's body is adapted to outdoor life of hunting, fishing, 
and farming. Persons who do their daily work in close, 
warm places, holding the body in an almost fixed posture, 

261 



262 



THE PEOPLES HEALTH 



have departed far from the life which the body has been 
used to through the ages. Hence there are many broken- 
down men and women among those who have adopted 
indoor life. Farmers are the healthiest class of people and 
liquor dealers the shortest lived. 

This chapter discusses the ill effects upon the health 
which may come from following different industries, and 
what employers and laborers can do to 
prevent or lessen those effects and prevent 
diseases of occupation. 

With the exception of firemen and their 
horses whose lives are shortened by sudden, 
violent exercise between times of complete 
rest, most modern work is too monotonous. 
The sameness of modern factory work is 
trying to the nerves. On the farm or in 
the old-fashioned shop, the work is con- 
stantly varied. There is nothing so wear- 
ing on the human body as months and 
years of monotonous toil. When men are 
turned into mere human machines, their 
spirits become depressed ; many injure 
themselves still farther by seeking excite- 
ment in drinking and gambling. 
Excessive hours of labor are contrary to public welfare. 
The ceaseless toil in factories where the hands are never 
still, the constant watching of machinery, the all-day 
standing, cannot safely be endured for a great length of 
time. Shorter hours prove to be better both for the worker 
and for the work done. 

When the worker is reduced by overwork to a state of 
constant fatigue, the heart, lungs, and kidneys fail to work 




A Factory Girl. 
Hair confined, apron 
strings short, sleeves 
short, she is safer 
among the whirling 
bands and wheels. 




Courtesy of Survty Associates, Me. 
A sweater and two sweat shop workers making stogies. 




Courtesy of National Cash Register Co. 
A factory need not have a dismal, dirty, dusty yard. 




Courtesy of National Child Labor Committee. 
Children Sewing after school until o or 10 p.m. 




From " The Bitter Cry ef the Children." 
These children (except the baby) work in a sweat shop. They were called from the 
photographer to return to work. Protection of children is the highest patriotism. 



INDUSTRIAL HYGJEXE 265 

properly in removing impurities. Then rheumatism, a 
disease hard to shake off, settles upon the worker. 

President Woodrow Wilson says : " Did you ever think 
that men are cheap and machinery is dear ; and many a 
superintendent will be dismissed for overdriving a delicate 
machine who wouldn't be dismissed for overdriving an 
overworked man?'' 

" Speeding-up " machines to increase the work done, 
speeds up the men and shortens the lives of the workers. 
Men and women come to hospitals who at forty or forty- 
rive years, are simply worn out human machines, thrown 
on the scrap heap. This is waste of human life. Even 
in slavery times, slaves lived under as good conditions for 
health as their masters. A wise employer knows that his 
interest and the interest of the laborer are mutual. A 
wise people realize that the energy and the health of the 
working men are the greatest source of strength and wealth ; 
that a nation of weak men with money piled up is weaker 
than a nation of strong men with little money. 

Working men will be more healthy and efficient in a 
factory that stands in well-kept grounds made attractive by 
green lawns and shrubbery than in a dingy factory with 
bare and dusty surroundings. There is a money value in 
pleasant surroundings. Many factories are moving to the 
suburbs. It is hoped to plan new factory towns better 
than the old. It is best for city workmen to live in the 
suburbs among trees and fields. Trolley cars make this 
possible. 

The successful manufacturer looks after proper lighting, 
pure air and water, and safe plumbing. In the best modern 
factory, the light falls through spacious windows, the walls 
are white or soft-tinted and clean. Any factory owner 



266 THE PEOPLE'S HEALTH 

who permits men to work with gas jets burning because of 
bad lighting, is wasting his money and the men's health. 
More windows should be cut in the walls. It pays to 
provide for the comfort of workmen, but if it did not pay, 
there ought to be no difference. It is our duty to protect 
the health of our fellowman whether it pays or not. 
1 Any man who loves his country will oppose conditions 
that weaken the workers. One of the worst sources of 
weakness is child labor. There are hundreds of thousands 
of children working in the factories of our land. What 
are the legal limits of the age and hours for child labor in 
your state? Children with bones still soft and tissues 
tender and growing are stunted by being put to work in 
factories, sweatshops, or mines. 

Little children not only work in factories, but they work 
twelve hours a day in some instances. Once, in a country 
needing soldiers, it was proposed to enlist boys in the army. 
Then a statesman said, " We must not grind the seed corn." 
Every one of the six cities having the highest death rate 
for children are mill cities. 

Modern Civilization threatens to destroy the Home. — Com- 
petition for wages makes it impossible for some men to 
marry and support a home. A married couple are much 
better off if the wife takes care of the home and the man 
works. If they both work, they earn more money, but 
their expenses are greater, the home is not so clean, the 
food so well prepared, nor their conditions of life so health- 
ful. If a married woman works she does not have to demand 
wages large enough to live on and she thus forces other 
women to take less than living wages. A married woman 
who works is the enemy of her home, her health, and of 
women who work and have no husbands to help support 







These women have brought their children to a caretaker before going to the factory. 
It is a great loss to national health that some women have less chance than the lower 
animals to care for their offspring. The mother who goes out to work and changes 
the method of feeding the baby cuts its chance of life in half. 




Courtesy of National Cash Register Co. 
Suction fans carry away particles of dust and brass Where the dust 
from the N. C. R. Polishing Room. is collected. 



267 




268 



INDUSTRIAL HYGIENE 



269 



them. When women work in unsanitary factories for 
long hours, the evil effects are seen in their children and 
grandchildren. 

Idle boys are usually dull' compared to boys who work 
part of the time. Farm work is educative, but boys on 
the farm should not be overworked or kept out of school. 
Of several hundred thousand children in the United States 
who cannot read or write, a large part live in the country. 
Boys should avoid going into 
" blind-alley " jobs like selling 
newspapers, blacking boots, or 
carrying messages. These im- 
part no skill and prepare for 
no better paid work. 

The chief sources of danger 
to the health in factories are 
fumes, dust, machinery, and 
too great heat and moisture. 

The belts, saws, pulleys, and Done with a Square Head 
1 , .* . , Planer. Finger guards on the ma- 

wneelS, It WltnoUt screens, chines would prevent such injuries. 

may cut or crush the work- 
man who falls against them. Much depends upon the 
workman himself. Nothing can protect a very careless 
man from injury. Workmen should get " the safety habit " 
and so work as to avoid risks. The machinery in cotton 
gins and sawmills is largely unguarded, and maiming and 
crippling occur daily. The author has gone to European 
sources for several pictures of safety devices for wood- 
working machines. Dr. Stresemann of Germany who had 
just visited many factories in the United States said in 
1913, " The conditions in most American factories in 
respect to safety are horrible." 




27c 



THE PEOPLE'S HEALTH 



Fumes (from brass, lead ; phosphorus, arsenic, quick- 
silver) shorten life. Workmen in such factories should 
breath through a strainer until they find work at factories 
with fume and dust removers. Painters and other workers 
in lead should keep the hands clean. 




Courtesy of Mr. S. C. Close, Welfare Bureau, U. S. Steel Co. 
Guards around belts, guard over safety head in planer, self-locking belt shifter. 



Irritating dusts, vegetable, animal, or mineral, are formed 
in manufacturing cotton and woolen goods, brooms, ropes, 
matting, wooden ware, horn and celluloid articles, felt 
hats, and in stone and metal working. Stone workers and 
metal polishers lead in the consumptive death rate. Cigar 
workers were next to them; but since the cigar-makers' 



IXDUSTRIAL HYGIEXE 



271 




Extended splitter. 
Protecting frame may 
be raised and lowered. 



union has encouraged care for cleanliness, fresh air, and 
prevention of dust, they have reduced the rate very much. 
Pearl button making is a very dusty trade and one third of 
the workers die of consumption. Laun- 
dry workers are very liable to consump- 
tion because of the overmoist air in 
laundries. Employees in glass works 
and foundries encounter destructive 
heat. 

Workers in dusty trades should 
breathe through an air filter tied to the 
nose. Stone workers and grinders of 
tools should protect the eyes with goggles. 
Dust should be sucked off through a 
tube by power-driven blowers. Excessive muscular work 
and overconhnement in dusty factories are fruitful sources 
of consumption. What is the use of the state spending 
millions of dollars on sanatoria and hospitals for consump- 
tives if we are to allow the conditions to continue which 
prepare the people for the disease and keep up the chances 

for infection? Smoke and coal 
dust are believed to cause 
pneumonia. 

Insurance companies save 
money by employing physi- 
cians to examine the insured, 
not only before insuring, but 
frequently thereafter. They 
discover the beginnings of disease and warn against the 
incorrect way of living that is bringing it on. Some 
companies employ visiting nurses to advise and help those 
who fall ill. 




Courtesy of British Factory Dept. 
Guard for circular saw. 




272 THE PEOPLES HEALTH 

A number of American factories (in Boston, Pittsburgh, 
Dayton, Chicago, and other cities) are using every possible 
means to protect their workmen, and to educate them into 
habits of protecting themselves. The greatest source of 
danger in factories provided with safeguards is the wrong 
point of view that many workmen have. They think it is 
heroic to take risks, but it is merely 
foolhardy. It shows lack of self 
regard and of respect for the duty 
owed to one's family. A man who 
tries to be a hero by taking useless 
risks has a false idea of heroism. 
This false heroism comes from moral 
cowardice. A man may thrust his 
Projecting set screws should arm through a whirling belt to reach 

not be allowed ; they have ., , , . 

caused many fatal accidents, an oil can or a monkey wrench for 
fear that if he steps around the 
machine for it others will say he has weak nerves. Hence 
safety training must be partly training in common sense 
and self regard which forbids the risking of life and limb 
by taking chances or "showing off." To the successful, 
self protection and caution become second nature. Those 
who are reckless usually fail and many of them shorten 
their lives or go through life crippled and weakened. 

References. — American Museum of Safety, 29 West 39th St., 
New York. Van Schaack's Wood-working Safeguards, J^tna Life 
Insurance, Hartford, Conn. L. C. Close, Welfare Dept. U. S. Steel 
Co., New York. Metropolitan Life Insurance Co., New York. Na- 
tional Cash Register Co., Dayton. International Harvester Co., 
Chicago. 

Applying for Work. — A healthy applicant is usually 
chosen before an unhealthy one. Good health shows itself 



INDUSTRIAL HYGIEXE 



273 




Courtesy of New York City Dept. of Child Hygiene. 
Applying for Certificates of Health and Fitness. This they must do in 
New York City if they wish to stop school and go to work under 16 years of age. 

in clear eyes, fresh skin, prompt attention, resonant voice, 
and in the way one sits, stands, and moves. 

A youth with his hair parted in the middle, his teeth 
decayed and breath bad, or a youth with his finger nails 
unclean and fingers stained with cigarettes, and his clothes 

smelling of them, may have 
to hunt long for a job. A girl 
chewing gum, or with high- 
heeled shoes, small waist, and 
uncomfortable clothes which 
are showy, instead of neat, 
her hair frizzled and her 
complexion artificial, has less 
chance of being chosen for work than others of more agree- 
able and healthy looks. 

One who is pale, thin, and nervous from ill health, or one 
with the vacant adenoid look, is at a disadvantage. To 




Courtesy of North German Woodworkers 
Association. 

Guard on a cut-off saw. 



274 



THE PEOPLE'S HEALTH 




Each pair of goggles 
has saved the loss of an 
eye from a flying bit of 
steel. 



have worked at many places may make an employer 
suspect that you are unreliable; but if you start into a 
" blind-alley " job, the quicker you change the better, 
that is, if you change to work that 
trains you and leads to more skillful 
employment. 

Selecting an Occupation. — A man 
who has no physical endurance, is not 
fond of seeing things grow, and likes to 
be much in crowds, should not try to be 
a farmer. One with bad hearing or weak 
throat and who is not fond of children, 
should not become a school teacher. 
One with a delicate frame and little strength will not 
make a good blacksmith. 

One who has weak lungs should not do work requiring a 
fixed, bent posture, and should not become a tailor, shoe- 
maker, watchmaker, seamstress, bookkeeper, typesetter, 
or stenographer. In such work bend at the 
hips, not at the shoulders. Those with weak 
lungs and delicate health should not become 
janitors, stonecutters, nor follow any other 
dusty trade. In fact, any one who, tempted 
by high wages, does such work where the em- 
ployer has not installed fans and other neces- 
sary preventives of dust and fumes, and who 
does not use a protector to breathe through, is 
making a fatal mistake. Trades which expose 
one to the fumes of poisonous chemicals, to sharp metallic 
dust, and those which endanger life or limb, should ,be 
shunned. A person with weak lungs should prefer out- 
door work. 




Safety tongs. 



IX DUST RIAL HYGIENE 275 

A man of halting speech should not become a lawyer or 
preacher. A physician should love natural science, a car- 
penter should be quick in arithmetic and skillful with his 
hands, a merchant should be orderly and of pleasant ad- 
dress. 

If the hands perspire freely, the relaxed condition of the 
skin should be overcome by means of cold baths, an open- 
air sleeping porch and simpler, more digestible food ; 









I 
1 



Courtesy of Xalional Child Labor Committee. 
A messenger boy at 10 p.m. This is a " blind-alley " job. See page 267. 

otherwise such persons should not apprentice themselves 
to learn watchmaking, bookbinding, leather working, mil- 
linery, dressmaking, or dentistry. One with varicose veins 
should not become a clerk nor stand long at work. 

One whose skin is very thin or tends easily to eruptions 
should not follow bricklaying, plastering, or tanning. A 
tendency to eczema, or skin eruptions, also unfits one to 
become a laundress, butcher, baker, painter, lacquerer. 



276 



THE PEOPLE'S HEALTH 




polisher, or cook, for the worker 
may be often disabled and lose 
much time. 

One who has had a heat stroke 
should not fire a furnace or work 
under ground, in laundries, or in 
very hot places. Those who are 
color blind or have weak vision 
should not be locomotive en- 
gineers or trainmen. 
Think of these things before 

applying for work, or you may find yourself doing work 

that you cannot do well or that puts you out of health. 

You will not want to keep on, but when you change, you 

will have to begin at the bottom again. 



Part of a Railroad Frog. Show- 
ing blocks to prevent switchmen's 
feet from getting caught. Injury 
to one is the concern of all. 



Test Questions. — What is the healthiest life for man ? What 
is the effect of confinement and monotonous work? What are the 
effects of too long a working day ? What is one cause of rheumatism ? 




Courtesy uj survey Associates, Inc. 
A Cigar Factory, Pittsburgh. Cigar makers suffer much from consumption. 
Notice the leaf tobacco stored in the workroom. This makes much dust, and is 
against the law. Are the factory laws enforced in your town ? The person who 
took this picture has already died of consumption contracted from cigar makers. 
This factory is well lighted. 



INDUSTRIAL HYGIEXE 277 

What did President Wilson say about overdriving a factory workman ? 
What is " speeding up "? What is the greatest source of a nation's 
wealth ? What is the effect of pleasant surroundings upon workmen ? 
What is said of imperfect light in the factory ? Of child labor ? What 
may be the effect upon the home of competition for wages ? What may 
be the effect of married women working ? What evidence is there of 
improper child labor on the farm ? Should a child be reared in idle- 
ness? 

What are the chief sources of injury to health in factories ? What 
is said of careless workmen? Foolhardy workmen? Give sources 
of injurious fumes. Of hurtful dust. What do some insurance 
companies do for health? What are some American factories doing 
for health ? Why do some men take useless risks ? 



CHAPTER XVII 
A SOUND BODY CONQUERS DISEASE 

You have no doubt wondered at those magical little 
warriors, the white blood cells, whose activity was described 
in the first chapter. This is only one of the many wonders 
of the body. The nerve cells are another of the many kinds 
of interesting cells that make up the bodily community or 
city. Like judges and teachers and officers, the nerve 
cells show the other cells when to act, for the bodily city, 
like our own people, is self-governing. 

The heart is the most tireless and wonderful pump that 
exists. When there is a great battle on against a multitude 
of hostile germs, it is necessary to send the white cells in a 
hurry against the enemy, and bring up fresh ones for re en- 
forcements ; so the nerve captains stir up the heart to beat 
fast, and command the road workmen to widen those won- 
derful roads, the blood tubes, along which the warriors are 
to march. This state of activity of the body is called a 
fever. If you were to put your hand over the heart or your 
finger on the wrist of a person with fever, you would find 
the heart and pulse beating fast ; you would see the skin 
flushed because of the opening of the roadways for the 
blood. If the fever becomes too high and the body too hot, 
then the nerve cells call for water, and order the sweat 
cells in the skin to deposit water and cool the body as it 
dries off the skin, and so take away the fever. 

The wise physician does not interfere with the efforts of 

278 



A SOCXD BODY COXQUERS DISEASE 



279 



the bod)- to cure itself, and he tries to keep others from 
meddling. The more ignorant a person is, the more he wants 
to meddle with his body, and the more ready he is to tell 
others how to cure themselves. He is sure that the drug 
advertised in the newspaper is the magic potion needed. 
The wise physician knows that in a body which has not been 




From " The Bitter Cry of the Children." {The Macmillan Co.) 
Xight Shift ix a Glass Factory. These boys walk 20 miles in 8 hours carry- 
ing hot bottles from work benches to the cooling ovens. Work builds up, overwork 
tears down. These boys cannot hope to develop bodies strongly resistant to disease. 

greatly abused, most diseases are self- limited ; they tend to 
get well of themselves if not made worse by blind meddling- 
It is better not to check the symptoms (or signs of the 
struggle) of disease. A cough is only Nature's way of 
blowing dust or phlegm out of the throat or lungs ; the 
stupidest thing to do is to take a patent " cough cure," and 
dry up the cough with the opium or other poisonous dope 



28o 



THE PEOPLE'S HEALTH 



which it contains. If it is to do its purifying work, the 
cough must loosen instead of dry up. At the same time 
strive to avoid breathing dust, or inflaming the throat by 
sudden chilling of the skin. When you begin to injure your 
lungs, Nature usually warns you by making you sneeze. 
If you do not take the warning, and get away from the dust 
or the cold, the friendly sneeze may not warn you again. 
The lungs were made for air, not 
for dust, although the lining cells of 
the windpipe have waving hairs, 
called cilia, which serve as chimney- 
sweeps to safeguard the lungs against 
a certain amount of dust. 

If you lose appetite the stomach is 
needing a rest ; do not eat until you 
are hungry again ; those who think 
themselves wiser than Nature will 
try to arouse appetite with dainties, 
The vapor bath is used to or w ^ mustard, pepper, and vinegar. 

refresh the skin after the ' r rr ° 




weakening effect 
clothing. 



of 



much The natural flavors of wholesome 
food will awaken the desires of the 
body cells when food is needed. If there is a rash on 
the skin, let it alone. Do not try to " cure " the rash, but 
try to purify the body by living differently. If you are 
sleepy, go to sleep, do not try to keep awake with 
strong coffee or tea. We can gain nothing by scorning the 
well-proved laws of health. Nature tries to keep us well, 
why not permit it ? Wise physicians do not allow patients 
to be waked up to take medicine. 

If a pain comes, do not dope it with cocaine or something 
else. Remove the cause, and live so as not to bring it 
back again. If a corn forms on the foot to protect the ten- 



A SOUND BODY CONQUERS DISEASE 



281 



der nerves and blood vessels beneath from an ill-chosen shoe, 
do not put a corn ring on it ; this will only force it to stand 
out more. Listen to Nature and throw away the shoe; 
or, if the shoe is too small, cut a hole in the leather. If too 
large, have an insole put in. Otherwise walking will be- 
come punishment and you 
may acquire a stumbling or 
strutting gait as well as a 
permanent corn. Ill-fitting 
shoes are not the only cause 
of deformed feet ; " flat- 
foot " may come from flabby 
habits of life. Sound, strong 
feet do not get corns quickly, 
or cause a cold every time 
they are wet, or remain cold 
while the body is warm. 

If you are thirsty, drink 
water. If not thirsty enough 
to relish cool water, do with- 
out drink. If perspiration 

J r r Southern* Home with wall of slats 

COmeS, let it Stay ; tO Wipe and shutters to keep out sun and admit 

. gulf breeze. A home without an open air 

It Off WOUld Only hinder the sleeping place is as lacking as a home 

effort of the body to cool without a bathroom - 
itself. But do not rush out into cold air when perspiring ; 
the body would not have started to perspire if the cells 
could have foreseen that. 

If you are tired, rest ; do not arouse yourself with a stimu- 
lant drink. When you feel bad, you may not want to 
work, and there wall be a good reason. For example, if a 
cold is beginning and you take a rest, perhaps go to bed for 
a day, the cold may stop or be a very slight one ; but by 




262 



THE PEOPLE'S HEALTH 



keeping at hard work, the strain of fighting the germs of 
the cold, plus the strain of work, may prove too much for 
the cells, and the cold may run into influenza. 

It is best to follow natural ways; that is, the ways most 
closely like those which the race followed as the body was devel- 
oped to its present state. Living naturally is the only way 
to insure health. Most people believe there is some short 
cut to health. There are many rascals, as you have learned, 4 
ready to take advantage of this belief in a cure-all. Other 
people that want to cheat Nature make a fad of one thing 
after another, each of which may have a little good in it 
One year it is the water of a certain spring, another year it is 
hot water to be drunk in immense quantities ; they keep 
at this until the stomach is relaxed by the heat and stretched 
by the load. The next year the fad is sour milk ; another 
year it is a certain kind of undergarments ; the next year 
the fad will be a serum ; and so it goes. It is as sensible as 
Ponce de Leon's belief in a fountain of youth. If a man 
breaks down his health drinking alcohol, a drug cannot 
cure him even if it has gold in it. Drunkards are now sent 
for treatment to farm colonies where they work out of 
doors and return to more natural ways of living. Dogs 
that live in the city often have the mange. Dairy cows 
take tuberculosis; cows on the range do not. Domestic 
fowls die readily, while quail do not. Our horses have 
many diseases which wild horses are free from. 

When an overworked city man sees that he must break off, 
or break down, taking tonics and beer will be useless. The 
constant tired feeling shows that the cells are using more 
energy during the day than is replaced during sleep, and 
nothing can prevent bankruptcy except a change in his 
home or business conditions. He has been undermining 



A SOUXD BODY CONQUERS DISEASE 283 

his general health. An acre of ground in the suburbs for 
his garden or orchard or chickens, to keep him at work out 
of doors a part of his time, will do more for his health than a 
sanatorium or hospital. At the same time, his orchard, 
garden, and poultry will supply more wholesome food than 
he could buy in a market. But if he waits too long, he will 
have to go to a hospital with little chance of ever being 
sound again. A " preventorium " is better than a sana- 
torium. 

One should not be stubborn when Nature warns him. 
Giddiness upon suddenly rising shows that the body is not 
in good condition. Constipation warns not to sit continu- 
ally (one can stand even while writing), but to walk more, 
and perhaps to drink more water, and to eat rougher food. 
Cold feet show sluggish blood flow, usually from lack of 
lively exercise or from too warm clothing or house. 

If one's hair begins to fall out and dandruff is abundant, 
this proves he has been starving, smothering, and overheating 
the scalp. His hair needs the fresh-air cure. He should not 
wear a hat in cloudy weather or on the street car, or when 
working in the garden, or on the street at night except 
during a cold wave. Frequent and thorough washing of 
the scalp may restore its vigor. This is better than to insult 
the cells in the scalp with a dirty " hair restorer." 

Fat is the savings bank of the body, but too much of it is 
a danger signal, a sign to change one's habits (eat less and 
work more) , or the fat will become oppressive and shorten 
life. Headaches or a bitter taste in the mouth may be a 
sign of indigestion. This does not mean to begin fussing 
about diet, starving, taking drugs or beef pepsin, but to 
mend the ways of living. It may be the part of wisdom to 
seek more open-air life and natural surroundings. But if a 



284 



THE PEOPLE'S HEALTH 



man continues a slave to business, as if money were the 
only thing in the world, he may find at fifty that by the de- 
posit of earthy salts in his arteries, they have become as 




An overworked city man at the first sign of weakened health should move to the 
suburbs where there is fresh air, quiet, and plenty of room out doors. 



A SOUXD BODY COXQVERS DISEASE 



285 



stiff and weak as a piece of old rubber hose ; there is no 
elasticity and soundness left ; a man with hard arteries or 
a bad heart cannot climb stairs or run a hundred yards 
without half smothering. 1 The idler is at the other ex- 
treme. A " short life and a merry one " usually means 
headaches and rheu- 
matic pains, a " sour 
stomach and sourer 
thoughts." Some 
people who do not 
work are tired most 
of the time and keep 
trying to guess what 
it is they eat that 
harms them. Idleness 
is the heaviest of all 
oppression. 

Young people should 
lead a simple life. 
A mother may expect 
a daughter to lose her 
rosy cheeks and fresh- 
ness if, besides going 
to a high school with 

a crowded course of study, the daughter devotes strength 
to music, art, and parties. This is the road to becoming 
a chronic invalid instead of a home maker. 

Girls, the future women of the nation, should have every 
advantage of health that boys have, and chief of these is 

1 Hardening of the arteries means hardening and loss of elasticity in the 
tissues in general. The body has been so inactive that it has not purified 
itself, and Nature had to use this material, the best she could get, for repairs. 




Girls in New York city schools taking gymnas- 
tic drill in open air. This is better than indoor 
exercise. 



2 86 



THE PEOPLE'S HEALTH 



loose clothing. A baby hampered by uncomfortable clothes 
will kick and scream and become frantic with rage, but a 
young miss will peg along demurely on high heels with toes 
pinched, head top-heavy, arms restricted, and waist 
cramped. Only a few are silly enough to believe the absurd 
beauty hints in the Sunday newspapers. Health is the only 
secret of beauty. Beauty and grace must be earned ; pow- 
der and paint, tight shoes and tight clothes, only bring more 
ugliness and awkwardness to the beauty seeker. She fails 
because she follows artificial instead of natural ways. 

The body tends so strongly to health that wrong living 
must be persisted in for a long time before health can be 
destroyed. There is a certain amount of reserve force natu- 
ral to every healthy animal body. Man is able to use 
up this reserve force when he is under the influence of al- 
cohol, drugs, or excitement. A person may be very tired ; 
if alcohol or excitement drives off this feeling for half an 
hour, he whTthen feel more tired than ever. 

You have learned of the body's many defenses against 




Fat Man and Thin Man. 
The " bay window " of the fat 
man is a sign of decay, and that 
he will not reach three score and 
ten. He has very little endur- 
ance, yet the "work cure" is all 
that will help him except eating 
less, for he has fed too often and 
too well. 

The thin man seems to be trying 
to " lean on his liver." He stands 
so as to squeeze his lungs. 



■(^(ffg 



Photographs from Dr. Louis J. Cooke's Manual of Personal Hygiene. Used by courtesy of author. 



A SOUXD BODY COXQUERS DISEASE 2 8j 

disease germs — of the outer barrier, or skin ; of the inner 
barrier, or mucous membrane ; of the germ-killing mucus, 
saliva, and gastric juice ; and of those two great defenses in 
the blood, the serum and the white cells. You recall how 
the white cells slowly change shape, flow around disease 
germs, engulf, and digest them ; in other words, they eat 
them. Thus the body escapes disease. But this does not 
always happen. The cells may have been paralyzed by 
alcohol or other poison. The germs may destroy the cells, 
live, multiply, and form toxins. The body, from overwork 
or strain, may not manufacture the antitoxin needed fast 
enough to conquer the disease promptly. The disease is 
more likely to be severe when the body receives a large dose 
of the germs at one time, or when the germs are a kind the 
body cells have never fought before. 

The body is usually supplied with a stock of various an- 
titoxins for all the toxins it has encountered, and is ready to 
manufacture more when needed. The white cells know how 
to combat all the germs they have experienced. The body 
can be prepared thus because a few of the germs of each 
disease have occasionally reached it and trained it to de- 
fend itself. When a person goes to Porto Rico or the 
Philippines or some other place with climate and germs 
such as the body has not been used to, the body has for a 
while a harder time defending itself. The strange new 
germs strike it down with illness. This means that the 
body has given up all other work except that of acquiring 
power to defend itself against its new enemies. 

Sometimes the body recovers from the disease without 
killing all the germs ; it merely learns how to keep down 
their numbers and prevent their multiplying. This is 
the case, for example, with typhoid and diphtheria " car- 



288 THE PEOPLES HEALTH 

riers." Disease is the process the body goes through with 
in adapting itself to new conditions. Americans that go to 
the Philippines usually become " acclimated " (that is they 
become used to the climate and germs), within a few months. 
If they drink alcohol the white cells may never conquer 
the germs of the new country. 

The adaptation of the body to new disease germs is be- 
lieved to take place in this way : At first the devourer 
cells, or white cells, do not like the strange germs and will 
not eat them rapidly ; so the body learns to form a sauce 
(opso'nin) which either weakens the germs so that they do 
not multiply rapidly, or causes the white cells to relish 
them and eat them up quickly. The devourer cells, it 
seems, will not eat all kinds of raw bacteria, but want them 
prepared with a sauce, and they want each kind of bacteria 
to have its own proper sauce (or opsonin). 

Persons are not all alike in their power to resist different 
diseases. When diphtheria or scarlet fever spreads, only a 
few acquire the disease. Those who escape have greater 
resisting power ; their army of defense seizes the germs and 
destroys them, instead of allowing them to increase in num- 
bers and make poison. If the disease gets a start, some 
persons, because the body is able promptly to manufacture 
antitoxin, and the blood cells quickly devour the germs, 
suffer very little and recover quickly. There seem to be 
different strains of the same kind of germ, as you have al- 
ready learned. At one time a mild form of the disease 
spreads ; at another time, a severe form spreads. Some 
think that the germs are made more poisonous 1 by living in 
very vile human bodies, and that if one must catch a disease, 
it is better to take it from those whose robust bodies have 

1 Experiments on guinea pigs indicate this,, 



A SOUXD BODY CONQUERS DISEASE 289 

weakened the germs and lessened their power to mul- 
tiply. 

At times a craze for health sweeps over the country, and 
every one is ready to do almost anything for health in a 
public way, provided most of the burden falls on public 
health officers. They are ready to do anything for health 




Campfire girls seek nature's ways. 

except the things which count the most, such as stopping 
useless self-indulgence, and following simple, natural ways. 
Public sanitation, by preventing sources of infection, is 
none the less necessary because a vigorous body conquers 
disease. One can hardly keep his body vigorous all the 
time, and the condition of the body affects the fighting 
power of the devourer cells and the power of the tissues to 
form antitoxin. It is the duty of each to avoid causes of 
weakness so that he may resist disease, not only for his own 
sake, but for the sake of the community. For a diseased 
citizen is not a good citizen, and is often a dangerous one. 

Test Questions. — What are the fighting cells in the body ? What 
is the duty of the nerve cells ? Tell things that happen in the body 
during a fever. What is said of meddling with the body? What is 
done for the body by a cough? What should one do if the appetite 



290 THE PEOPLE'S HEALTH 

is lost ? If one becomes sleepy ? If a corn begins to form ? If one 
is tired ? What are natural ways ? What is said of fads ? What 
are the proofs that natural ways are best? What course is advised 
for an overworked city man who is losing his health ? What do cold 
feet show? What is shown by falling hair? Excessive fat? What 
happens to the arteries after years of wrong living ? What is said of 
the health of girls ? What is said of the reserve force in the body, and 
how it may be used up ? 

What are the defenses of the body ? When does the body have its 
hardest battles with germs ? What is said of germs which are entirely 
strange to the body? What has happened when one remains a carrier 
of disease germs ? What is disease ? What is an opsonin ? What is 
said of different strains or races of the same disease germ ? What is it 
that counts the most for health ? Why will the public prevention of 
infection never cease to be necessary? Why is health necessary if 
one wishes to be a safe citizen ? 

Illustrated Studies. I. Draw on blackboard and explain figures, 
pages: 205, 208, 220, 221, 223, 228, 231, 248, 252, 253, 256, 257, 262, 
269, 271, 272, 274, 276, 286, 291. 

II. Questions on pictures : Describe the adenoid face. Just where 
do adenoids grow? How do pupils at flat desks lean? State two 
ways to get a proper slope : p. 213. Name the four cities with highest, 
and four with lowest, death rates. Describe a sterilizing plant. 
How is a room made ready for fumigation? Do the sixteen flats of 
the open-stair house all have bathrooms? Outdoor entrances? 
Can the 7-cent lodging house be kept sanitary? Describe the three 
ways of cleaning Washington's streets. How may a well be made a 
typhoid well? Describe a tubercular country home. Where do 
flies hatch and visit? Describe facial expression of a hookworm 
victim. How long is a hookworm? How may health and dwelling 
house affect each other? p. 254. Describe iceless coolers : p. 178, 258. 
What kind of windows has the factory with green lawn and flowers ? 
What is safe clothing for a factory girl? Describe sweatshops. 
What mothers cannot treat their babies fairly? How may dust be 
removed from factories? How prevent accidents from belts? Cir- 
cular saws? Splitters? Revolving shafts? Cut-off saws? Flying 
particles? Log tongs? Railroad frogs? What change of position 
should be made by the workers in the cigar factory ? 














@n 


^— — -^ 




life 



The layers of the skin that 
germs cannot pass. 



The mucous lining stops 
and the mucus kills germs. 



The serum of the blood 
(shown separated from the 
clot) that forms antitoxins 
and opsonins. 






Cells of the liver that 
destroy poisons. 



Cells which form saliva 
that kills germs. 



Gastric glands which 
form a juice that kills 
germs. 




Blood cells. A white cell (larger 
the red) is seen to the right. 



than 




A lymph gland which filters the tissue 
juice, or lymph, before it reaches the 
blood. These glands are the favorite 
dwelling place of the white cells which 
act as sentries and capture and feed 
upon germs before they reach the blood. 



These figures are from " The Hygienic Physiology," a book devoted to personal hygiene. 
THE MANY DEFENSES OF A HEALTHY BODY 

2QI 






/.it. 






'A> ; 



ft K 






'■J "\'h''.{ r 










52/ courtesy of the Rockefeller Institute of Medical Research. 

Two photographs (through microscope), taken 48 
hours apart, of the same bit of tissue removed from 
the heart of A chick and kept suitably warmed and 
nourished. This marked growth of cells and their 
fibers shows that cells have a vitality of their own ; 
hence the body will keep itself sound if our cells are 
Pf allowed the simple conditions of life which they need. 



\ ^/^ '(./ ni [ \ S \ A \ V ^ < > (Part of the larger photo is not shown.) 



CHAPTER XVIII 
CELLS AND TISSUES 

Gladstone said, "It is the first duty of a statesman to 
care for the people's health" ; it is the first duty of the 
citizen to care for his own health. If personal hygiene 
be neglected, efforts for public health will be in vain. To 
care for the body intelligently its structure or anatomy 
must be learned and its mode of action, or physiology, 
understood. 

The small units of which the large unit, called the body, 
is made, are called cells. The cell is a particle of living 
substance containing a nucleus, or center of activity.- A 
bodily cell resembles a one-celled animal. You learned 
that a disease germ is a one-celled vegetable. One-celled 
animals and vegetables and 
bodily cells can be seen only 
with a microscope. 

The figure on this page shows 
a microscopic view of a one- 
celled animal called the ame'ba. 
It contains a nucleus, or active The Ameba (magnified). It 

' , moves by pushing out a false foot, 

center, d, a contractile bubble, c, e < and flowing into it. See figure on 

next page. 

which swells and shrinks. At 

times the ameba sends out finger-like projections, e. Like 
other one-celled animals it does not die of old age ; it is 
immortal. Later in life, instead of dying it will divide 
into two smaller cells. A portion of the nucleus goes into 
each cell and they soon become as big as the first one was. 

293 





294 T HE PEOPLES HEALTH 

Any animal large enough to be seen with the unaided 
eye is made up of many simple cells living side by side and 
helping each other in a brotherly way. We shall learn 
that large animals have many advantages over one-celled 
animals. They also have a disadvantage, which finally 
results in death : — The ameba takes oxygen from the water 

with the whole surface of 
its body. It swallows a 
food particle that touches 
it anywhere simply by en- 

The path of a crawling ameba and its ^ ° "" ° 

four shapes after each half minute. (Mag- around it. Any Undigested 
nified.) . . mi 

portion is easily thrown 
out. The cells of the larger animals interfere with each 
other since all cannot be on the surface where they can 
rearch food and easily rid themselves of waste material. 

Venice, you know, has streets of water. We could hardly imagine 
a city without streets or roads and without ditches or sewers to drain 
away waste. So in the community of cells forming the human body 
certain cells make liquid roadways called blood tubes (see figure, 
page 315) to serve these purposes; other cells form muscles which 
are admirable for movement ; the nerve cells become teachers and 
governors. The skull is the governor's palace, and the cells in the 
nerve centers there send out messages on long branches which serve 
as telegraph wires for this wonderful community. The cells lining 
the digestive tube are like farmers and turn crude material into food 
ready for use by the cell-citizens. See the figure on page 10; it 
shows five kinds of cell-citizens. 

Some of the cells, most wonderful of all, are like soldiers and police- 
men, to protect from public enemies. These are the white blood cells 
which destroy bacteria and other dangerous enemies by simply 
swallowing them whole and digesting them. There is no grave- 
yard in the community; dead or injured cells are disposed of by 
white cells in the same way. A place that is sore and swollen usually 
means that the white cells have crowded to a bruised or injured spot 
or a point of infection, that they may devour the dead cells or the 



CELLS AND TISSUES 



295 



invading germs. This is also called an inflammation. After the dead 
cells are removed, other cells called plasma cells subdivide and turn 
their own bodies into new tissue to replace the tissue removed by the 
white cells. Have you ever seen how the white cells remove a splinter 
from your finger? Thus the cells work together and help each other 
to keep the body sound and strong. No 
change in any cell in the body is a matter of 
indifference to any other cell in the body. 

Do any of the cells, like naughty citizens, 
ever become selfish or quarrel ? In a healthy 
body every cell works for the common good 
and for itself; but cancer cells only eat, they 
will not work. They are criminals who rob 
and poison neighboring cells. Death of the 
body follows cancerous growth unless it is 
promptly removed by a surgeon. 

To the Teacher. — To make sure that the pupils 
get a definite idea of each tissue it will be well to 
appoint several pupils to draw on the blackboard, 
ready for use in recitation, the six figures of tissues 
referred to below. This plan will prove helpful in 
other lessons. 

Similar cells, side by side, doing the 
same kind of work are said to form a 
tissue. The cells in a tissue look alike 
and act together. To understand the s % 
structure of the body it is first neces- NmvE Tlss ^ om thc 
sary to know the different tissues and brain - Note the delicate 

arms by which nerve cells 
their work. keep in touch with one 

Nerve tissue is composed of cells with 
many branches ; these cells are capable of receiving and 
transmitting messages. See figure on this page. Muscular 
tissue is made of long cells that have the power of short- 
ening and lengthening, spoken of as contracting and re- 
laxing. (See figure, page 318.) The nerve and muscular 
tissues are sometimes called the master tissues, while the 
other tissues are called the supporting tissues. 





296 THE PEOPLE'S HEALTH 

The cells in connective tissue have formed a great abun- 
dance of long fibers which help to make the organs, or the 
working parts of the body, by holding the other tissues in 

place in each organ. See 
figure on this page. 

The outer layer of the skin 
and the lining of the mouth 
and digestive tube are made of 
epithelial tissue. See first two 
figures on page 291. It has no 
fibers, and its cells are packed 
closely together, like bricks or 

Connective Tissue. Notice cells J ° 

(dark) among fibers, free cells, b, and tiles in a pavement. Germs 
a tiny blood tube, d, to bring food. 

may infest the skin but they 
are harmless unless they penetrate the epithelial tissue. 
These cells protect, but other epithelial cells form pocket- 
like or tubular organs called glands, with tubes, called 
ducts, to empty them. Glands secrete, or form and 
deposit, useful fluids called secretions. Secretion of wastes 
to be cast out is called excretion. 

Fatty tissue is soft, for it is composed of round cells filled 
with oil and of connective tissue fibers which hold the cells 
together. 

Bony tissue is a hard, stiff tissue, for its cells deposit enough 
lime to take up most of the room. In bony tissue there 
are many small cavities filled with a red marrow (see 
figure, page 297), and some long bones have large hollows 
containing yellow marrow which is chiefly fatty tissue. 

Cartilage tissue, or gristle, is very tough, for it has more 
fibers than cells. 

Fibers are thread-like. Membranes are skin-like sheets. 
The mucous membrane is seen on the lips. It lines many 



CELLS AND TISSUES 297 

inner organs and keeps itself supple by secreting a slimy 
fluid called mucus. 

Test Questions. — Define anatomy, physiology, cell, nucleus. 
What does a cell resemble? Sketch an ameba and name its parts. 
What becomes of amebas that are not killed? What advantages 
has a one-celled animal? What disadvantage in a many-celled 
animal leads to its death? Of what are the smallest blood tubes 
made up (figure, page 315)? Compare the body's cells with mem- 
bers of a community. 

Describe what happens at sores and swollen spots. 

What is a tissue? Describe the parts making up each of the 
following tissues: nerve, muscular, connective, epithelial, fatty, 
bony, cartilage tissue. Define gland, duct, secretion, excretion, 
fiber, membrane. 




Microscope view of Bony Tissue, showing the 
holes for the blood tubes and the encircling cavities 
where the bone cells lie. 



CHAPTER XIX 



SOURCE OF THE BODY'S ENERGY 



Light, sound, electricity, heat, motion, chemical action, 
are all forms of energy. The total amount of energy in the 
world is always the same. No energy is ever destroyed, but 
energy in one form can be changed to energy in another form. 
For example, the energy of motion is changed into heat if 
you rub a button on your sleeve for several minutes (try it). 
Heat and motion are being constantly produced in our 
bodies by a chemical action resembling combustion or slow 
burning. {Chemical action binds two 
or more substances together into a 
compound or breaks up a compound 
body into two or more simpler ones.) 
The heat produced in the body is about 
equal to the heat from the continuous 
burning of two candles. The amount 
of work which the body can do in one 
day would lift 900 tons one foot high. 
What supports this burning in the 
body? The breath supplies the air to 
the fire, and the food we eat supplies the fuel. As in 
a stove or furnace fire, the chief part of the air used is 
oxygen gas and the fuel is chiefly carbon. Just as carbon 
dioxid gas is the chief substance resulting from coal 
(carbon) in a furnace, so it is the chief waste product 
of the life process. Carbon dioxid is heavy (see figure 

298 




Carbon dioxid, a heavy 
invisible gas, can be 
poured down in the direc- 
tion of the lines and will 
smother out a candle. 



SOURCE OF THE BODY'S ENERGY 



299 



on page 298) ; it gets its name because it is composed 
of carbon and oxygen. The process of uniting is called 
oxidation. Very rapid oxidation is called burning. One 
fifth of the air is oxygen. Oxygen is so active a gas that 
iron will burn in pure oxygen. See figure on this page. 

About one eightieth of the body's weight is consumed 
daily ; at this rate the fasting body would consume itself 
in 80 days. Records of starvation show that death occurs 
when about one half of the body has been consumed, or 
in about 45 days. The life process keeps the body at a 
temperature of 98!°. A few degrees above or below this 
temperature, consciousness is lost. 

Heat is a product of life ; it also supports life. Heat 
makes the egg to hatch and the seed to sprout. The living 
body supplies the proper conditions for 
the slow gradual union of food and 
oxygen. The heavy inactive gas, car- 
bon dioxid, results, and leaves the body 
in the breath and is carried through the 
air to the plants. 

The chemical energy of the food and oxy- 
gen is given up to the body, but where did the 
food and oxygen get their chemical energy ? They 
got it from the plants and the plants got it 
from the sunlight. The sunlight falls upon the green leaf of the plant 
and enables the leaf which has absorbed carbon dioxid from the air 
to split the inactive gas into two parts, carbon and oxygen. The 
gas oxygen is sent out into the air ready to be breathed ; the carbon 
is stored up by the plant in sugar, starch, oil, or other food. See figure 
on next page. Carbon dioxid is sometimes called carbonic acid gas. 

Every fruit, every seed is a little bundle of solar energy ready to 
make a new plant or to give its energy to animals that eat it. So 
you see, the plant gathers energy from the sunlight, the animal uses that 
energy in the body. 

The more energy you expend in work, the more you must eat, 




An iron spring burning 
in pure oxygen gas. 



3°° 



THE PEOPLE'S HEALTH 



and the faster and deeper you must breathe. The colder the weather 
or the thinner the clothes you wear, the more heat the body must 

make in order to keep warm. So in cold 
weather we must eat more and breathe 
more, just as we put more fuel in the 
stove and turn on the draft a little more 
to keep the house at its usual tempera- 
ture. 

The body stores up part of the food as 
sugar in the blood and as animal starch 
in the muscles and liver ready for instant 
use ; this is like the coal already in the 
hot furnace of the locomotive. Some of 
our food we store up as fat in fatty tissue 
to be used only in an emergency after the 
sugar and starch are exhausted. This is 
more like the coal in the tender of the 
locomotive. Food is also used to repair 
the cells and tissues. This corresponds to 
the iron and brass with which the locomotive is repaired. But we 
should not think the body is a mere machine. No mere machine could 
care for and regulate itself as the human body does. 




Water 



Diagram to illustrate that the 
plant, helped by the sun, stores 
up carbon in starch and gives 
out oxygen gas. 



The food used for growth and repair is called protein. 
Protein is always made partly of nitrogen. The food 
we eat is of three kinds; — coal foods (or fats and oils, 
sugars and starches), proteins, minerals. When sugars 
and starches are burned in the body, muscular work is 
chiefly produced ; when fats and oils are burned, heat is 
the chief result. Do not think that fats produce heat 
merely, sugars produce work merely, and that proteins 
only repair tissue; protein produces heat and energy also. 
Hard workers feed the furnace of life plenty of sugar to 
prevent the muscles from wasting away. Surplus sugar 
is turned into fatty tissue. 

The energy in any food is measured by finding the amount 
of heat and motion set free by it on complete burning in 



SOURCE OF THE BODY'S ENERGY 



3°! 




Soot (carbon) from half- 
burnt tallow blackens the 
saucer. 



oxygen. The calorie, or heat unit, is also used as a food 
unit. It gives an exact measure of the heating power of 
food, a less exact measure of its energy power, and a still 
less exact measure of its tissue- building power. Fats and 
oils, sugars and starches, are called 
carbon foods, or coal foods, because 
they contain much carbon. See the 
two figures on this page. 

Mineral foods help the proteins to 
build tissue. The chief mineral sub- 
stances used as food are water and 
common salt. We need iron for our 
blood and lime for our bones, but 
we cannot use iron filings or lumps 
of lime as food. Iron and lime must 
be prepared for us by the sun and 
the plant, and we eat them in plants 
or in the flesh of animals that got 
them from plants. Tomatoes and 
beef are both red because of the iron 
in them (iron rust, you know, is red). 
Milk contains more lime than lime 
water. Our bones cannot use the lime in lime water, for 
it is in the mineral state ; it would not help us and might 
even hinder digestion. We must get lime for our bones 
from milk, grains, and other foods. 

Thought Questions on This Chapter. — Why should there be a 
balance between the income and outgo of the body? If one eats less 
food each day than the body needs, what happens ? What happens 
if one eats more than the body needs ? A boy from 9 to 13 years needs 
as much food as a man. Why ? Between 14 and 19 years he needs 
more. Why ? What are the years of fastest growth ? A girl older 
than 11 years requires as much food as a woman, though she works 




Heat sugar on a stove. 
Notice that it is charcoal 
(carbon) when half burned. 



3° 2 



THE PEOPLES HEALTH 



less. Explain. Who will need a larger proportion of tissue-maker 
in his food, a child or a grown-up ? Why ? One who begins to train 
for a contest, should increase the proportion of protein. Why ? 

Beginning about 50 years of age the food, especially the protein, 
should be diminished about one tenth during each decade. Explain 
why. At about what age are men and women most likely to acquire 
a double chin and grow fat ? At about what age are old people apt 
to become lean and wrinkled ? 

The strength increases during sleep. Why ? Does sleep change 
the looks ? Why is the last hour of sleep called the beauty sleep ? 
What balance has been lost if one gets very fat or very thin ? If 
one eats less than is needed for the day's work, why must there be a 
loss of weight ? What is then consumed in place of food ? Will loss 
or will gain in weight probably result from increased sleep ? Shorter 
sleep ? Cold baths ? Warmer clothing ? Long walks ? Cold weather ? 
Idleness ? Increase in amount of coal foods ? Draw up a plan of 
living to reduce weight. To increase weight. 

Test Questions. — Name several kinds of energy. Is energy 
indestructible? Give examples of change from one form of energy 
to another. Name two kinds of energy produced by the body. 
What is their source? What is said of oxygen? Carbon dioxid? 
Define oxidation. Why does doing without food result in death? 
What is the normal temperature ? 

What becomes of the carbon dioxid given off in the breath ? Where 
does the plant get energy with which to split 
the oxygen from the carbon ? What does it 
do with the carbon? What becomes of the 
oxygen ? Why do we have keener appetites 
in cold weather ? Compare food in the body 
and coal in the engine. Why is the body not 
a mere machine ? 

What element does protein food always 

contain ? What are the three kinds of foods ? 

What do the several kinds of foods do for 

us? Name the four coal foodstuffs. How 

prove by experiment that two of these con- 




If a glass is placed over 
a candle, it will burn only 
until the oxygen is used up. 

tain carbon? 



Why can we not eat iron and lime as food ? 



CHAPTER XX 

THE CONTROL OF THE BODY 

The cells of the body work in harmony with each other 
largely because of chemical substances given off by each 
cell which act as messengers between them. An example 
of this is when the white cells are attracted to dead or 
injured tissue by the substances such tissue sends into the 
bloodstream. Germs are found and attacked because 
they make their presence known in the same way. A 
hunting dog is drawn to a rabbit by the odor it gives off. 

The nerves also help the various parts of the body to 
know each other's needs and work in harmony. If the 
nervous system is like the telegraph system with its wires, 
the system of chemical messengers is like the post office 
system with its letters. 

The chemical messengers of the body are called hor'- 
mones. A hormone must be able to pass quickly through 
the walls of blood vessels so as to reach the parts to be 
stimulated, and it must be easily destroyed by oxidation 
or otherwise so that its action may come to an end promptly. 
The organs in the body called ductless glands have as their 
only known function to form chemical messengers, or hor- 
mones. These glands have no ducts ; they form internal 
secretions which pass directly into the blood that is always 
flowing through them. 

There are two small ductless glands, called the adrenals, 
lying one on the upper end of each kidney. See figure on 

303 



304 



THE PEOPLES HEALTH 




Adrenal Gland, 
sliced through. It 
grows on kidney but 
is not related to it. 
v. vein. 



this page. The cells composing these 
glands are remarkable for the large 
amount of granules they contain. It is 
believed that these granules readily 
change into a hormone called adrenalin. 
When this occurs the adrenalin passes into 
the bloodstream, causes a tightening of 
the blood vessels, and raises the pressure 
at which the blood is flowing. When a 
drop of adrenalin is put under the skin, the 
spot becomes perfectly bloodless. 

When a man or beast sees a sudden 
danger, the. adrenals at once secrete adrenalin, anger rises, 
sugar flows from the blood to the muscles, the muscles be- 
come stronger, the blood pressure rises, 
and the heart becomes stronger, fatigue 
and exhaustion disappear, and the 
man or beast is thus made ready to 
conquer the enemy or overcome the 
danger. Most remarkable of all, under 
such conditions the blood clots more 
quickly, so that if a wound is received 
in the contest it is less liable to prove 
fatal. 

The thyroid gland is a soft lump in 
the neck. It can be felt on the sides 
of the windpipe below the Adam's ap- 
ple. It consists of two oval bodies 
connected by a narrow band. See figure on this page. // 
extract of a sheep's thyroid is given, the pulse is quickened, 
appetite is increased, output of protein rises above the in- 
take, fat is diminished. // the thyroid shrinks or loses its 




The Thyroid Body, 
or gland, on front of wind- 
pipe. 



THE CONTROL OF THE BODY 



305 




The Pituitary Body, P, in a 
deep pit at base of brain. 



function, mental activity is blunted, connective tissue be- 
neath the skin thickens, hands and face appear swollen and 
puffy, pulse is slowed, and the temperature falls below normal. 

In the bone forming the floor of the skull there is a deep 
depression dipping down nearly 
to the nose. Lying snugly at 
the bottom there is a small 
onion-shaped body, the pitu- 
itary (see figure on this page). 
It stimulates growth, especially 
of the bones. If its front half 
is removed or becomes diseased, 
a dwarf results, for the bones of 
the animal do not grow. If it 
becomes enlarged, there follows 
an abnormal growth of the hands and feet and lower jaw. 
If the disease occurs during childhood, then, in response 
to the pituitary hormone, the bones of the trunk and limbs 
attain great length and a giant is the result. 

Thus you see the ductless glands are both important 
and powerful. 

The Nervous System. — Chemical messages must be 
carried by the bloodstream. Nerve messages travel much 
more quickly, for they pass along nerve fibers. The nature 
of the nerve message is not known. Some physiologists 
hold that it is electrical. Others think it is a wave of 
chemical change like that which travels along a train of 
powder when one end is lighted. The hormone messages 
about which you have already studied travel only between 
the inner parts of the body, but many of the nerve currents 
start at the surface of the body and guide us in our relations 
with the outside world. 



306 



THE PEOPLES HEALTH 




A Nerve cut 
across and enlarged 
to show its fibers. 



As you have learned, nerve cells have much longer 
branches than other cells. These branches, or nerve 
fibers, bring all parts of the body in close communication 
with one another. A complete nerve cell is 
called a neuron. It consists of a gray cell- 
body, many short branching fibers, and one 
long fiber, the axon. See figure, page 295. 
The axon has a white fatty covering. The 
nerves which carry messages between various 
parts of the body consist of many axons 
bound together (see figure on this page). A cluster of cell- 
bodies is called a ganglion. 

Nerve fibers are of two kinds : sensory, by which impres- 
sions are received, and motor, by which impulses are sent. 
The sensory nerves come from the skin, mucous membrane, 
and other organs whose condition must be reported. The 
motor fibers go to the muscles, glands, and other organs 
which are to be excited to action. 

The brain is in the hard skull and looks not unlike a 
beef's brains. It is divided ^rfT 7 f ""v^ 0ER EBRUM 

into right and left halves by 
a deep trench. The largest 
part, the part with which 
we think, is called the cere- 
brum (see figure on this 
page) . The portion beneath 
the hinder part of the cere- 
brum is called the cerebellum, The Human Brain> showing j ts folds> 
or little brain. It serves to convolution, 

harmonize action when several muscles act at once. 

The brain is gray on the outside because the gray cells 
lie on the surface in a layer called the cortex ("bark"). 




THE CONTROL OF THE BODY 



307 




Spinal Cord and roots of 
a pair of spinal nerves. 



See figure on page 306. The brain is mainly white beneath 
the cortex because of the white fibers which connect all 
parts of the brain and pass down to 
the spinal cord. ^V/S\ 

The spinal cord is in the spinal col- 
umn. Like the brain it is divided into 
right and left halves ; but, unlike the brain, its gray matter 
is within and its surface is white, for its fibers run near the 
surface. See figure on this page. Nerves pass out to all 
parts of the body through openings between the vertebrae. 
Movements are of two kinds, voluntary and involuntary. 
The involuntary, or reflex movements, follow quickly the 
exciting cause ; for instance, when the 
finger touches a hot stove, or something 
touches the eyelids, or when the mouth 
waters at the sight of food. 

A voluntary act, after many repeti- 
tions, may be transformed into a reflex act. 
Walking without thinking of it is an 
example. A person playing dance music 
has been seen to fall asleep over the 
piano and yet continue to play correctly. 
A neroe center is a group of nerve cells 
having one definite work to do. The 
part of the spinal cord within the skull 
is called the medulla (figure, page 306). 
It contains many nerve centers. Among 
them are the centers for sweating, blush- 
ing, blanching, swallowing, vomiting, 
coughing, and the center for breathing, called the vital knot. 

The nerve impulses which regulate the heart and other internal 
organs do not come directly from the brain and spinal cord, or central 




Sympathetic Sys- 
tem, its nerves and gan- 
glia (one of the two 
chains) . 



3 o8 



THE PEOPLES HEALTH 



nervous system. They come through the sympathetic system. This 
system consists of many nerve fibers and two chains of ganglia near 
the spinal column. See figure on page 307. The sympathetic 
system relieves our minds from superintending the organs inside the 
trunk ; we cannot control them by will power, but the sympathetic 
system keeps them in harmony with each other. 

Hygiene. — As it takes two reins to control a horse, 
so it takes two sets of nerves to control most of our activities. 
The heart's beat is kept up by the salts in the blood, but 
there is one set of nerve fibers (from the sympathetic 
system) tending always to increase the heart beat and 

another set (from 
the medulla) tend- 
ing to block (in- 
hibit) their influ- 
ence and slow the 
heart beat ; the 
two together keep 
the rate right. 
Vasomotor nerves 
control the size of 
the blood vessels. 
There is one set of 
vasomotor nerves 
(the constrictors) 
tending to tighten 
the blood vessels 
and another set (the dilators) that tend to block (inhibit) 
their influence and allow the vessels to swell. Between 
the two sets they are kept at about the right size. See 
figure of vasomotor nerves on this page. 

A stimulus or stimulant is anything which arouses nerve 
action ; that which benumbs nerves and weakens nerve 




Vasomotor Nerves and blood vessels controlled by 
them. G, G, ganglia. 



THE CONTROL OF THE BODY 



309 



action is called a narcotic. Alcohol is a narcotic ; yet a 
drink of alcohol sometimes increases the heart beat and 
flushes the face. This seeming contradiction is explained 
by the following facts : Alcohol benumbs and weakens 
the nerves which hold back the heart beat. This removes 
the check upon the nerves which tend to hasten the heart ; 
alcohol also weakens the constrictor nerves that tighten 
the blood vessels and the pressure of the heart then dilates 
the vessels and flushes the skin. Perhaps you have seen 
some drinkers with a "rum blossom" on the nose or the 
whole face a fiery red. Alcohol gives heat to the body 
but causes it to be lost by the rush of blood to the skin. 
. The first alcoholic drink taken is repulsive unless its 
true taste is concealed by sugar, fruit, or other means. 
One drink is a danger. After a few drinks Nature ceases 
to warn ; a desire for it may even arise. If the habit is 
not stopped, the desire soon becomes a craving, and the 
habit may never be broken. The drink craving usually 
takes several months, in some cases, years, to become a 
man's master ; the habit of taking morphine or cocaine 
may overmaster a victim in two weeks. He who when 
ill and in pain insists on a physician giving morphine is 
doing a reckless thing. 

Cold is a natural stimulus, but heat, unless too great, is soothing 
to the nerves. Oxygen is a natural stimulus, carbon dioxid is a natural 
narcotic. Alcohol, tobacco, tea, coffee, drugs, are artificial stimulants 
and narcotics, for they are new to the race and the body has not 
learned sure and reliable reaction toward them. As a stimulus a 
short, brisk, cold bath is preferable to a cup of tea, for it leaves no 
burden of poison for the body to get rid of. Morphine will narcotize 
and bring sleep, but hard work or play will cause enough carbon 
dioxid to form in the tissues to soothe the nerves and bring a delicious 
drowsy feeling at bedtime. 

Stimulants supply little or no energy lo the body; they arouse the 



3io 



THE PEOPLES HEALTH 



body to use its own energy. An artificial stimulant causes the body 
to use a wasteful amount of energy. An habitual stimulant is some- 
times called a tonic. 

Fresh air, sunlight, foods of pleasant flavor, laughter, and merri- 
ment are better tonics than strychnine or whiskey or bitters, as every 
one will admit. A poisonous coal-tar drug (acetanelid, antipyrin, 
antifebrin) may stop a headache by benumbing the brain or depressing 
the heart, but these remedies weaken the heart. Their use is be- 
lieved to be one cause of the great increase of heart disease in recent 
years. The best way to cure headaches is to cure the cause. 

The hands of a cigarette slave are often trembly because of over- 
stimulated nerves. His skin is usually pale, 
because tobacco stimulates the constrictor 
nerves. 

Neuritis is inflamed, painful nerves ; it is 
sometimes wrongly called rheumatism. The 
principal cause of neuritis is confining the" 
diet to overcooked food, polished rice, wheat 
flour not made of the whole grain, canned 
goods. Oranges and lemons take the place 
of fresh vegetables in winter and help to 
prevent neuritis. Beriberi is one form of 
the disease. See pages 104 and 105. 

Neurasthenia, or nervous exhaustion, 
brings with it self-consciousness, self-pity, 
loss of confidence, indecision, exaggeration, 
a dread that something untoward will 
happen, habitual worry over trifles, and general weakening of health. 
It is caused by bad mental habits, close confinement indoors with 
little hard work for the muscles, overwork, idleness, loss of sleep. It 
is cured by removing the cause and changing the mental habits. 

The false thinking and bad mental habits usually found in neuras- 
thenia may start from some mental shock or nervous strain. A 
child has sometimes become a nervous wreck because an exaggerated 
importance is attached to his passing in school. The mind represses 
the unpleasant memory of a shock or strain and will not look at it 
frankly and calmly. The repression causes the nervousness. The 
cure is to bring it clearly into consciousness and no longer be afraid 
of the dark memory. Sometimes such nervous shocks leave a bad 
habit, or muscle spasm, such as a jerky motion of the head or foot, 




A fresh nerve cell, A, 
granules plentiful, nucleus 
round ; an exhausted nerve 
cell, B, fewer granules, 
nucleus shrunken. 



THE COXTROL OF THE BODY 311 

twitching of the eye, a grimace, or stuttering. The first step in 
curing the habit is to bring clearly into consciousness how it was 
caused. To cure stuttering requires long practice on the offending 
words. 

Nerve specialists nowadays give few if any drugs, but try to instill 
into the patient sounder and clearer mental habits. A fixed idea 
may take possession of the mind, such as that one has heart disease, 
is mistreated or persecuted, or that some matter of small import is 
so disagreeable that it cannot be borne. A better mental habit is 
the best remedy, together with fresh interests and keeping busy at 
work that is worth while. Few persons are entirely free from fixed 
notions, or obsessions. A nervous person is generally one who has 
had bad nervous training or has associated with nervous persons. 

To the Teacher. — It will be well to call for volunteers to recite on "Mental 
Hygiene,'' the chapter (page 164) on hygiene of nerves already studied. 

Test Questions. — What is the use of chemical messengers in 
the body? Give an example. What qualities are needed by a 
hormone, or chemical messenger? Where are hormones formed? 
Where are the adrenals ? What is the effect of adrenalin? How does 
it prepare the body for a contest? Where is the thyroid gland? 
What happens if it shrinks? Where is the pituitary? What causes 
giants? Dwarfs? 

Compare chemical messengers and nerve currents. What is a 
neuron ? Name its parts. What are the two kind of nerves ? What 
is the cerebrum? Cerebellum? Medulla? Explain why the brain 
is gray without and white within. Why is the reverse true of the 
spinal cord? Compare voluntary and involuntary movements. 
A reflex act requires how many neurons? What is a nerve center? 
Xame nerve centers in the medulla. What is the structure and 
function of the sympathetic system? What are vasomotor nerves? 
What are the two kinds ? 

Define stimulant. Xarcotic. Explain the effect of alcohol upon 
the heart. What is said of forming the alcohol habit ? Drug habits? 
What is a natural stimulus? An artificial stimulant? Give ex- 
amples of each. What is the advantage of one over the other? 
Xame a natural narcotic. Do stimulants supply energy? What 
is a tonic? Give one cause of the increase in heart disease. 

What is neuritis? Beriberi? The cause of neuritis? Its cure? 
What is neurasthenia? Signs? Cause? Cure? What is an ob- 
session? Examples? How removed? 



CHAPTER XXI 



THE CIRCULATION 

The cells would die in a short time if the blood stopped 
flowing, for no food or oxygen would reach them nor waste 
material be carried away. A person faints if his heart 

stops beating for 
only a few seconds. 
The blood, which 
may be called a liq- 
uid tissue, is slightly 
alkaline and equals 
about one twentieth 
of the body weight. 
The cells in the 
blood are of two 
kinds, red and 
white. The liquid 
part of the blood 

Human Red Blood Cells (magnified 840 diame- . 

ters). Notice they are thinnest at the center. Most IS Called plaSMCL. 

of them cling together in rolls. There are millions in one -r, r o rr { P c fnnrl tn 

drop of blood. (From Handbook of Physiology by 1L Cd < rriet5 IUUU LU 

Austin Flint, m.d.) the tissues and car- 

bon dioxid away. The red blood cells carry oxygen to the 
tissues. These cells are round, flat, and thinner towards 
the center. See figure on this page. The white blood cells, 
as you have learned, defend the body. They do not have 
to remain in the bloodstream, but, because of their re- 
markable power of self-motion, they visit various tissues. 

312 




THE CIRCULATION 



313 




Soon after blood is drawn from the body fine strings of 
a protein called fibrin form in the plasma, entangle the 
corpuscles, and cause clotting. (See third figure, page 291 .) 

The red blood cells are formed in the red marrow of the 
bones. See figure on this page. The white blood cells are 
formed in lymph glands. See figure, 
p. 37 ; also last figure, page 291. 

The heart moves the blood; it 
is a double pump made of active 
muscle. The blood leaves the 
heart by blood tubes called arteries, Where the red blood Cells 

are Born. Cavities containing 
These keep Subdividing Until they red marrow (two wrist bones, 

become fine tubes called cap'il- part ° l lg 
laries, which lead to the return tubes called veins. 
The circulation of the blood is almost a closed circuit, since 
there are no openings, except in the spleen, from blood ves- 
sels to tissues. The capillaries are so small that not more 
than two red cells can float through side by side, and 
sometimes they go single file. These cells 
are elastic and bend out of shape in a narrow 
place. See figure on page 350. With a mi- 
croscope the circulation in the web of a frog's 
foot or the tail of a fish may be studied. 

The capillary wall is made of only one layer 
of cells with branches that interlock. See 
figure on page 315. If we except the cells 
that form the walls of the blood tubes, the blood does 
not anywhere come in contact with the living cells of 
the tissues. A middleman is needed between the blood 
and the cells. This middleman is the tissue juice, or 
lymph filling the spaces between the cells (you have seen 
it come out of a broken blister). Sugar, salt, oxygen, 




The Heart. 



314 THE PEOPLES HEALTH 

hormones, and other things readily soak through the thin 
walls of the capillaries into the. lymph and the lymph 
gives them to the cells. Carbon dioxid formed in the 
tissues passes through the lymph spaces and capillary 
walls into the blood. 

Lymph is slightly yellowish except that after a meal the lymph 
bringing fat from the small intestine is white. Since the plasma 
soaks through the capillaries, there would soon be too much lymph 
if it were not drained off. This is done by tubes called lymphatics. 
They begin with open ends in the lymph spaces and unite into two 
large lymphatics which empty into the large veins found beneath 
each collar bone. Thus the lymph becomes blood plasma again 
and dropsy is prevented. Every time the body is moved, jolted, or 
shaken, the lymph is moved along and valves with tubes allow it to 
move in only one direction. Study the lymphatics in the palm and 
near the surface of the trunk as shown in the figure on page 37. 

The one exception to the circulation being closed is in the spleen. 
There are many gaps in the walls of the blood vessels passing through 
it. This structure makes the speen a great blood filter. The splenic 
cells take up from the blood particles of foreign matter and worn-out 
red cells. The spleen is purplish ; it has involuntary muscle fibers and 
beats once a minute. 

The Pulse. — The blood vessels are elastic and the 
arteries expand as the blood is squeezed into them by the 
heartbeat. This wave of expansion is felt as a beat, or 
pulse, and it is noticeable in the arteries as far from the 
heart as those in the wrists. The kidneys and most organs 
expand slightly, or beat, as the pulse passes through them. 
The pulse does not reach to the veins. 

Every contracting muscle squeezes the blood forward 
in the veins that flow through it or beneath it. The 
muscles cannot squeeze the blood backward in the veins 
because of the many small valves which open only toward 
the heart ; in the arteries the back flow is prevented by 
the pressure from the heart. 
; There are two pumps in the heart ; each pump has a 



THE CIRCULATION 315 

receiving chamber, or auricle, and an expelling chamber, 
or ventricle. The right auricle receives impure blood from 
the veins of the body and passes it down to the right ventricle, 
which sends it to the lung capillaries for oxygen. It comes 
back pure to the left auricle, goes down to the left ventricle, 
which expels it into the arteries. Passing next through 
the capillaries, it becomes impure and goes back through 
the veins to the right auricle and so repeats its ceaseless 
rounds. In the figure 
on next page color all 
the vessels red that 
carry pure blood and 
color those blue that 
carry impure blood 
(blackboard or note- 
book). 

Hygiene. — As you 

Till Capillaries are built by exceedingly thin, flat 
know What the blood cells. Notice their interlocking strands; also 

does for the cells it is their nuclei - 

easy to see that the question of the disease or health of 
any organ is largely a question of whether it gets a bountiful 
supply of fresh, good blood. If the blood flows freely 
through the organ, it will be warm, sound, well nourished, 
and keep free of wastes. If because of pressure from other 
organs or because of impure blood the supply of good 
fresh blood for an organ is lessened, the resistance of that 
organ is lowered and it becomes the ready prey of disease. 
Soon the starved cells degenerate. 

Helps to the Blood Flow. — The expansion of the chest 
when a breath is drawn helps to suck the blood of the 
veins into the chest and on toward the heart. Muscular 
activity of any kind helps to move the blood in the veins. 




316 



THE PEOPLE'S HEALTH 



In fact it is not the heart that moves the blood back from 
the feet and legs when one is standing; the contractions 
of the leg muscles squeeze the blood upward in the veins. 
This explains why it is so painful to stand for any length 

of time without moving. Faint- 
ing would soon bring relief. 

Any organ needs more blood when 
it is working than when it is rest- 
ing. Arteries have a muscular 
coat in their walls. The dilator 
nerves dilate the arteries of a work- 
ing organ and more blood flows 
through it. At the same time the 
arteries in other parts contract, 
just as if, when water is needed 
in the bathroom, it should be shut 
off in the kitchen. Do not study 
hard right after eating and draw 
the blood from the digestive or- 
gans. Mark Twain usually wrote 

Diagram of Circulation lying down or half reclining SO the 

through heart, lungs, and body. 

With pencil shade the vessels blood flowed more freely through 

carrying impure blood. , . , -n i i 1 

his bram. Reckless persons have 
been known to drive the blood to their brains by studying 
with the feet in cold water. Why is one inclined to be 
drowsy after a heavy meal ? 

Smoking tobacco, especially in the form of cigarettes, often 
causes what is called " tobacco heart" ; the heart thumps 
alarmingly for a while, then flutters weakly, then thumps 
again, and so on. 

Summer complaint (see page 59), is often caused by the 
blood with its protecting power being withdrawn from the 




THE CIRCULATION 317 

intestinal walls to the skin. This allows bacteria to multi- 
ply in the digestive tube. It is treated by cool baths, light 
clothing, and keeping the child in a cool place. 

Lack of energy in hot weather is due to want of blood 
in brain and muscles. It has been sent to the skin to 
cool off. Energy is regained by eating less so as to make 
less heat and by wearing very thin clothes. Women are 
usually more sensible than men in both these respects. 

The quantity of blood is important ; its quality is still 
more so. Anemic persons have not enough red cells in 
their blood. What will cure ane'mia and bring roses to 
the cheeks? Living much out of doors and eating plenty 
of green vegetables and fruit. See photographs, pages 
^, 23, 31, 35, 153, 279, 283, 292. An open-air sleeping 
porch or a bedroom with all windows open during the 
hours of sleep is the best blood purifier. 

Test Questions. — Why is the blood essential to the life of the 
tissues? What is the use of plasma? Red cells? White cells? 
What is fibrin? Clotting? Where are red cells formed? White 
cells? Describe the heart. What are arteries? Veins? Capilla- 
ries ? What is the structure of the capillary wall ? What goes out 
of and what into the bloodstream through the capillary walls? Ex- 
plain how the lymph is a middleman between the blood and the cells. 

What is lymph ? Its color ? Its course ? What is remarkable in 
the spleen's structure? What is its color? Location? Functions? 
How does blood leaving the spleen differ from that entering it ? 

What is the pulse? What causes the blood to flow in the veins? 
What prevents its being squeezed backward ? What is an auricle ? 
A ventricle? Where does the blood become pure? Describe one 
complete round trip, or circuit. What is the common cause of 
disease in an organ ? How does breathing aid the blood flow ? How 
does muscular activity aid it? Why is standing still so painful? 
When an organ becomes active, what happens to the bloodstream in 
it ? What is often the cause of summer complaint of children ? Of 
lack of energy in summer ? What is anemia ? How is, it overcome ? 
What is the best blood purifier ? How do cigarettes affect the heart ? 



CHAPTER XXII 



THE MUSCLES 



Anatomy. — The muscles weigh nearly as much as all 
the rest of the body. The red flesh of animals is muscle. 
A piece of boiled beef may be easily separated into strands 
the size of cords. Each strand is a 
bundle of fibers inclosed in a thin 
sheath of connective tissue. A fiber 
picked to pieces under a microscope 
with the aid of needles is found to 
consist of still smaller fibers called 
fibrils. These last are the true mus- 
cle cells. They are crossed by fine 
dark lines ; and the muscle is called 
striped muscles. See the figure on 
this page. The striped muscles 
move the bones ; they can act quickly 

Sketch of eight fibrils of a ' J . J 

voluntary or striped muscle and are called voluntary muscles, 
though they sometimes act reflexly. 
There are also unstriped involuntary muscles which 
are pale and act more slowly; they are never under the 
control of the will. They are made up of spindle-shaped 
cells without cross stripes. See figure on next page. 
They are not attached to bones, but are tubular, or hollow. 
The walls of the blood vessels and of the digestive tube are 
made of involuntary muscles. We cannot blush at will 
nor control the heartbeat, nor stop anything after starting 
to swallow it. 

318 





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ifi 




HIS 


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i . 1. 




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THE MUSCLES 319 

The glistening sheets of connective tissue which bind 
the fibers of voluntary muscles into bundles extend beyond 
the muscles and form tough unstretchable cords called 
leaders, or tendons, which He in a small space and connect 
the muscles with the bones. Bend the elbow or knee 
forcibly and feel the tendons ; if drawn tight they feel 
not like flesh, but almost as hard as wires. 

Physiology. — Voluntary muscles are arranged in pairs. 
A muscle which bends, or flexes, a joint is called a flexor; 
it has as its antagonist an extensor, which extends, or 
straightens, the same joint. 

When a muscle contracts it changes in shape but not in 
size. As it becomes shorter and thicker 
it exerts a pull and can do work. By 
use a muscle grows larger, firmer, and 
redder; by disuse it becomes small, Sb Tspindie-iike fibrib 
flabbv, and pale. of ^striped muscles 

(enlarged) . 

Where does muscular energy come from? 
To move the clapper of an electric bell the wires take electric 
energy from battery cells to the bell when the button is 
pressed. The nerves do not carry the energy with which 
the muscles contract. The muscle cells have already ab- 
sorbed food and oxygen from the blood and thus stored up 
energy ; the nerve merely stimulates them to action. When 
a gun is fired, the energy already stored up in the powder of 
the cartridge is set free by pulling the trigger. The con- 
traction of muscles produces not only motion but also 
heat. (When have you noticed this in your own expe- 
rience ?) 

The protein and fat eaten supply very little energy to 
the muscles. Their energy usually comes from the oxida- 
tion of sugar. Muscles get sugar from the starch and 




32 O THE PEOPLE'S HEALTH 

sugar we eat. Beef tastes sweetish because of sugar 
stored in it. Candy is good food for a football player, 
a farmer, or any one who does hard work with muscles. 
A very active child who plays in the fresh air can have pure 
candy, but candy will make an inactive child fretful ; for 
he has no use for it and it may turn into an acid or, at best, 
will only form fat. 

Hygiene. — They do not look like it, but many fat 
people are poorly nourished. Their muscles are flabby 
and weak, including the muscles that work the lungs, so 
they easily get out of breath. Another surprising thing is 
that many lazy men eat more than hard workers ; but it 
is the overeating that makes them lazy. They eat more 
food than is needed ; it ferments, or spoils, in the digestive 
tube and forms toxins which weaken their nerves and cause 
a tired feeling. Since they are always tired they are said 
to have been "born tired" by those who do not know the 
physiology of it. In other cases the energy is sapped by the 
hookworm in the intestine which consumes the blood of the 
poor victim (page 253), or by the tapeworm which feeds upon 
the food of its victim. The man who hires a hookworm 
victim or takes him as a partner will probably lose money. 

In natural healthy fatigue the energy in the muscles is 
not exhausted, but the activity of the muscles gives rise 
to carbon dioxid which weakens the junction between the 
nerve fibrils and the muscle fibrils so that the stimulus can 
hardly pass into the muscle. A bath may relieve the 
fatigue by aiding the blood flow so that the carbon dioxid 
is washed out. Sleep also allows this to be done and re- 
pairs to be made. Sleep is as necessary as food in keeping 
up the energy. After middle age the nerves report fatigue 
less promptly and old people are apt to overwork. 



THE MUSCLES 321 

Fatigue is as much a result of nerve exhaustion as of 
muscle exhaustion. Hence the more numerous the nerves 
and muscles employed and the finer, more delicate the work, 
the quicker exhaustion comes. For this reason writing with 
the ringer movement is more exhausting than writing 
with the forearm movement. 

Those whose regular work is done mainly with small 
muscles should, in hours of recreation, choose exercise 
which uses the large muscles, and the other way about. 
An artist can refresh himself by chopping wood ; a wood- 
chopper might find recreation in learn- 
ing to draw. 

While a muscle is contracting it is 
receiving many nerve impulses each 
second. Even when it is not con- 
tracting it is receiving a slight nerve 
stimulus which keeps it in tone, so A round-shouldered boy 

sketched from above. 

that healthy muscles constantly exert 

a slight pull on the bones and keep ready for instant 

action. Some people waste energy by keeping their 

muscles too tight and they look stiff, do not move with 

grace, nor talk in mellow tones. They should learn to 

relax. 

Constant contraction of the same muscles causes them 
to become "bound" so that they will hardly stretch, or 
relax, at all. In many people with flat chest the upper 
part of the chest has become muscle-bound, the shoulders 
being round and bound forward by tight, hard muscles. 
See figure on this page. People who wear high heels 
and walk without a springy step often have the calf of the 
leg become so muscle-bound that a free springy step is pain- 
ful. The feet may be gradually set free by the use of 




322 



THE PEOPLE'S HEALTH 



canvas shoes or other flexible low-heeled shoes, by prac- 
ticing dancing in the bare feet, and by learning to step off 
on the ball of the foot. 

On the other hand, the muscles of some people have so 
lost their tone that they are slack and flabby. Such persons 
are likely to shuffle and slouch. Dr. Murphy of the Navy 
says that the majority of American men and boys have 
good tone and strength in the leg muscles 
but are muscularly weak from the waist 
line up. The signs of this are round 
shoulders and protruding abdomens. See 
photographs, page 286. Flabby abdominal 
muscles as a result of belts, corsets, or 
tight clothing are almost the rule with 
grown-ups whose occupation does not 
require vigorous, muscular work. 

Constant changes of style between high and 
low heels, large and small waists, high and low 
waists, with too much indoor life and too little 
exercise, accounts for the general flabbiness and 
poor state of health so common with women. 
muscles may bring a train of serious evils. The 
stomach, spleen, liver, the intestines, and even the kidneys sag down 
and cause the abdomen to bulge out (see figures on next page). When 
an organ is out of position it will not do its work well. The weight 
of the organs pulls upon the sympathetic nerves, which tug at their 
connections with the spinal nerves, hence backache and headache 
result. The only way to return to health is to strengthen by special 
exercises the abdominal walls so that they will hold the organs back 
in position. Then an active body, sensibly clothed, will soon regain 
health and retain it. Headaches are suffered by women who take up 
general gymnastics while their trunk muscles are still flabby. 

Most work to-day tends to a one-sided life with overuse of the nerves 
and disuse of most of the muscles. This is true not only in offices, 
but in factories. Yet many in addition wear tight shoes and clothes 
and thus forbid themselves free exercise. They invite years of suffer- 




The waist of a nat 
ural woman (Greek) . 

Flabby abdominal 



THE MUSCLES 



323 



ing, great expense, and a shortened life. If awakened to the evil of 
their ways they can soon acquire firm muscles, steady nerves, a free 
flow of the bloodstream, and the bearing and color of health. 

What is called "muscular rheumatism" may be a bacterial infec- 
tion of the muscles and joints. The germs may enter the body at 
broken gums, decayed teeth, catarrhal nose, or diseased tonsil. When 
the happy hunting ground of bacteria is cleaned up and healed up, 
the "rheumatic" pains cease. 




One figure shows the organs of the trunk in their normal places ; the other shows 
them after a snug-fitting corset has been worn for a few years. 



To the Teacher. — It may be well to call for volunteers to recite' on "Hygiene 
of Work and Play," the chapter (IX) on muscle hygiene already studied. 

Test Questions. — Name a fact which proves the amount of 
work to be done by the muscles. Do people live as if they believed 
it? Describe structure of striped and unstriped muscles. Other 
differences. Of what is a tendon formed? How are voluntary 
muscles arranged? What occurs when a muscle contracts? What 
are the effects of use and disuse? What is the source of muscular 
energy? What food is of especial use in great muscular activity? 

What are causes of laziness? Where is the cause of fatigue 
located? How does rest overcome fatigue? Is it more tiring to 
use many small muscles or a few large ones? Why? What kind 
of exercise should be chosen for recreation? What is muscle tone? 
What does the term "muscle bound" mean? Give examples. The 
muscles in which region are most liable to flabbiness? W T hat evils 
may result ? Why do people nowadays usually get so little exercise ? 
To what may "rheumatism" in muscles and joints be due? 



CHAPTER XXIII 
THE SKELETON 

Anatomy and Physiology. — The skeleton, or hard 
framework supporting the body, is made up of a little 
more than 200 bones. There are flat bones like the shoulder- 
blades and skull bones, there are long bones such as those in 
the legs and arms, and there are irregular bones like those 
which form the wrists, ankles, and spine. See figure on 
next page. 

The many joints between the bones allow of varied 
motion. The ends of the bones are covered with gristle, 
or cartilage, to lessen friction and the effect of sudden jars. 
The surface of the cartilages is very slick and supplied 
with a slimy liquid that the joints may move freely. Tough 
sinews, or ligaments, hold the bones together at the joints 
and set limits to their movements. 

The arms and legs revolve on the trunk by means of 
ball-and-socket joints at the shoulders and hips. Hinge 
joints at the elbows and knees allow motion to and fro. 
In the hand there is one ball-and-socket joint (where?) 
and many hinge joints (where?). The bones of the skull 
are united by immovable joints. 

The back "bone" or vertebral column is made of small 
bones called vertebrae joined together by thick pads of 
gristle, or cartilage. The column rests on a wedge-shaped 
bone which with the curved hip bones make up the hip 
girdle, or pelvis. 

324 



THE SKELETON 



325 



The twenty-four ribs are attached 
to twelve vertebrae behind. The 
front end of the upper seven pairs of 
ribs join to the flat breast bone in 
front. Each of the next three pairs 
is attached by long cartilages to the 
pair next above. See figure on this 
page. The front ends of the last two 
pairs of ribs are free (" floating"). 
Thus the region of the five lowest 
pairs of ribs is not a firm cage like the 
upper part of the chest, or thorax, and 
the portion of the chest near the waist 
is more useful in breathing. 

The shoulder blades and collar bones 
together make up the shoulder girdle, 
which rests upon the chest. Thus the 
entire weight of the shoulders and the 
arms which hang from them is sup- 
ported by the chest. If the shoulders 
slip forward, they weigh down the 
chest in front. 

The thigh bones are the largest 
bones. They fit into deep sockets 
in the hip bones. Because of the 
depth of these sockets and the narrow- 
ness Of the hips, the legs do not have lowing (do not, unless required, 

learn the Latin names) : skull 

as free movement as the arms. There (cranium), upper and lower jaw 

(superior and inferior maxilla), 
cheek bone (malar) , bones of spine (vertebrae), collar bone (clavicle), shoulder blade 
(scapula), breast bone (sternum), ribs (costae), upper arm (humerus), fore arm (radius 
and ulna), wrist (carpus), palm (metacarpus), fingers (phalanges), hips (sacrum and 
innominata), tail bone(coccyx), thigh (femur), knee cap (patella), shin bone (tibia), 
splint bone (fibula), ankle (tarsus), instep (metatarsus), toes (digiti pedis). Mark 
L after names of long bones, F after flat, and I after irregular bones. 




The Human Skeleton. 
In this figure locate the fol- 



326 



THE PEOPLES HEALTH 



is a knee cap to protect each knee joint. (Straighten your 
knee and move the knee cap with your hand. Its shape ?) 
The lower leg, or col}, has two bones, the splint bone which 
is buried in the muscles, and the shin bone which can be felt 
just beneath the skin. The many small bones of the foot are 
bound together by ligaments and form an elastic arch which 
is higher on the side of the foot next to the other foot. 

You have noticed that when a bone is burnt most of it 
is left and is white and brittle. This part is limy; the 
part that burns up is gelatin-like, or gluey. In childhood, 




■ ;; mt 




rj|LjV^%5p 




#= 


L '''^aLSPr 





The bones and cartilages of small children are very tender. At the left is shown 
the unsafe, and at the right, the safe, way to lift a young child into a bath. 

there is more of this gelatin and the bones are not so easily 
broken, but deformity is more easily acquired. If deform- 
ities are not corrected in youth, they are hardly ever 
corrected later. Explain why. 

Hygiene. — Persons in delicate health are more liable 
to acquire deformity. Ill-nourished bones are soft and 
readily undergo alteration in shape. Weak muscles bring 
a tendency to lapse into a heap ; strong muscles keep the 
body balanced and the bones in shape. Sound bones are 
not easily fractured by a fall or strain. When the bones 
of a drunkard are broken, there are sometimes cases of 
delayed union, showing that alcohol has weakened the 
vitality (or vigor of the cells). 




THE SKELETON 327 

Correct postures while sitting, standing, or walking are 
essential to the development of a normal figure. It is 
hardly possible even to breathe well if one sits or stands 
improperly. The clothing should allow freedom to the 
body to stretch and readjust itself at will ; the body of 
a savage has the pliancy 
and grace of a cat or tiger. 

If tight shoes or a deep 
respect for corns and bun- 
ions has led one to walk flat- The bones of *** foot , form a beautiful 

elastic arch. 

footed or with stiff ankles, 

and he would learn to walk well, he must learn to sway the 
whole body forward from the ankle and to remove the weight 
largely from the heel and carry it lightly upon the ball of 
the foot. Walking with the weight upon the heel is an 
advantage only in soft or plowed ground where a springy 
step is impossible. The weight should not be thrust down 
upon the heel through rigid joints as if too lazy to use 
the muscles of the calf and thigh. 
With a springing step, the chest ex- 
pands, the head is carried easily, and 
a fine poise is attained which makes 
every motion a pleasure and gratifies 
a foot covering with room the eye of the beholder. The Greeks, 

for the big toe. ^ sh()wn by thdr statueS) wa }k e d with 

the whole body even to the tips of their toes. The body 
is so perfect a unit that even an easy carriage of the head 
depends upon having the feet well shod and well used. 

Applications. — The boys should inspect the heels of 
each other's shoes and the girls the heels of the girls. 
If the heel is worn most at the back edge, what fault of 
gait is shown ? If it is worn at the outer side ? 




328 



THE PEOPLES HEALTH 



Hump back, round shoulders, and flat chest are usually 
parts of one deformity. The cartilages of the spine, from 
uneven pressure continued for weeks, become wedge-shaped, 
with the thin part of the wedge in front. Habits which 
tend to produce this deformity are : i , bending at the 
shoulders and neck instead of at the hips when the work is 
hard to see or low in front, as in hoeing, or on a low work- 
bench or desk (see photographs, pages 158, 186) ; 2, weak 
muscles, especially at the back (see figure, page 335), and 
failure to keep erect (see photograph, page 163) ; 3, carry- 
ing the hands in the pockets (the 
habit may be overcome by swing- 
ing the arms while walking) ; 4, 
sleeping curled up in bed (to 
keep warm) ; 5, sitting slipped 
down in the seat or chair; 6, 
clothing too tight at waist or chest 
(see figure, page 329), or with 
a coat collar that is too tight 
over the back of the neck and 
pulls the head forward; 7, ade- 
noids, though more often adenoids and flat chest both 
result from general weakness ; 8, bicycle-riding (see photo- 
graph, page 154) with low handle bars. 

Lateral curvature of the spine (see photographs on page 162) may 
be caused by : i, writing at a desk that is too high; 2, habitually carry- 
ing a book-satchel or other weight in the same hand; 3, standing too 
much on one foot; 4, sleeping on the side without a pillow after early 
childhood; 5, a certain defect of vision (astigmatism) leading to the 
habit of holding the head to one side. 

Applications. — 1. Count those in your class who have flat chests 
and round shoulders and reckon the percentage of the deformed. 
2. Examine your chest and shoulders at home unclothed before a 
mirror. Does your head protrude ? Do the shoulder blades lie flat ? 
(A fine back is flat across the shoulders.) 




The figures show the natural form 
of the trunk and (at left) round 
shoulders from wearing tight corsets. 



THE SKELETON 



3 2 9 



Several Defects in School Seating must be guarded against. Nine 
tenths of spinal deformities begin during school years. The curves 
children get are apt to stay with them. The following is a list of 
possible defects with their possible results: 1, desk too low (stoop 
shoulders, flat chest, congestion of eyes, nearsight) ; 2, desk too high 
(right shoulder too high, lateral curvature of spine) ; 3, seat too far 
to rear of desk (for results see i, the rear edge of the desk should be 
exactly above the front edge of the seat) ; 4, too high a seat (feet dangle, 
pressure on nerves and blood vessels, foot goes to 
sleep) ; 5, too low a seat (a crouching attitude with 
results as in 1) ; 6, desk nearly flat (flat chest, 
round shoulders, injured eyes; the slope should 
be about 40 ; see figures, p. 213); 7, seat with 
straight back (restlessness, slipping down). The 
back of the seat should be curved to fit the back 
and partly support it below shoulder blades. If 
not adjustable, the seats for each grade should be 
in three sizes. 

.4 p plication . — 1 . Let half of pupils, accompanied 
by the teacher, inspect the seating of the other 
half, testing the seven points above. Teacher 
may record credits for the pupils finding and prov- 
ing defects. 2. To test lateral curvature of spine 
test whether one shoulder is higher than the other 
by tacking a strip to a post with one nail ; bring 
end of strip down until it touches one shoulder, 
turn and see if it will touch the other shoulder. 

Clothing, though needful for warmth, is probably 
the greatest single cause of human deformity and 
weakness. Its effects are plain from the bald head to the crooked 
toes with their corns, bunions, and ingrown nails. The most serious 
evil effects of clothing are to weaken the skin, displace the vital 
organs, and deform the skeleton. 

From love of neatness, mothers usually buy clothing barely large 
enough for the active child, and the growth of the child leaves the cloth- 
ing far too small before it is worn out. See picture on this page. If 
the clothing is tight over the chest or across the shoulders, it is useless 
constantly to remind the child to sit up, as it does so only for a moment. 
If a child gets a flat chest, there is little hope of stopping the frequent 
coughs and colds which follow unless and until the flat chest is cor- 
rected. 




The mother said 
the child's dress was 
large enough, but see 
how it gaped when 
unbuttoned and she 
drew a full breath. 




330 THE PEOPLES HEALTH 

If suspenders are not of the right kind, they flatten the chest. 
The further out suspenders pass over the shoulders, the more they 
pull the shoulders down and depress the chest. They should lie 
close to the neck behind and pass obliquely to the sides in front to 
allow the chest to expand between them. At the back the suspenders 
should either cross without rigid connection or be attached to the 
arms of a short lever (see figure on this page) ; one end of this lever 
goes up with the shoulder that is raised, while the other goes down 
with the other shoulder. Knickers are more easily supported than 
trousers. They should be supported not by a 
tight belt around the waist, but by a loose belt 
resting on the hips. 

A sprain means that sinews (liga- 
ments) have been stretched or torn 
from the bone. The sprained joint 
should be kept in hot water for an hour 
or two, then wrapped so as to keep the 
Home-made lever sus- J oint immovable. After a day or two 
penders. when the the joint should be used, though cau- 

spine bends to side, one 

shoulder needs morespace, tiously ; for if not used, it may become 

the other needs less, and ..„ 
the lever transfers the ^lin. 

slack - Applications. — i. Study the working 

of a properly made suspender (made by a pupil, see figure 
on this page). 

2. Make a test of those who have most frequent colds 
and coughs. Are their chests flat, or shoulders round? 

3. Call for volunteers to come before the class that their 
posture and gait may be studied, and, if necessary, cor- 
rected. Is the head well balanced? Is the chest flat, 
swelled out like a bantam, or just right? Is the weight 
lifted on the ball of the foot? 

4. Practice chair carry, and four other ways of carrying 
injured (see Appendix). 

5. Practice the triangular bandage (Fig. 8, Appendix). 



THE SKELETOX 331 

Test Questions. — How many bones in the skeleton ? Three 
shapes of bones, with examples? Locate ball-and-socket and hinge 
joints. Use of cartilage? Use of ligaments? What makes up the 
vertebral column? The hip girdle? How many ribs? How at- 
tached in front? What makes up the shoulder girdle? Locate 
thigh bone, kneecap, splint bone, shin bone. How are the bones 
arranged in foot ? What chemical stuffs are found in bone ? 

Result to skeleton if muscles are weak ? What is necessary to the 
growth of a normal figure? Discuss faulty gaits and their causes. 
Describe a correct gait. How did the ancient Greeks walk? What 
did your study of heels show ? 

Give six causes for round shoulders and humpback. Give five 
causes of lateral curvature of spine. State the seven ways in which 
school seating may be wrong and the bad effect of each defect. Are 
any pupils in your school seated wrong? What three evil effects 
from clothing? Why are the shoes and clothing of children usually 
too tight? Discuss suspenders. Is there a connection between 
posture and frequency of colds or coughs? How must a sprain be 
treated? Wliat ways do you know of carrying the injured? 



CHAPTER XXIV 



THE LUNGS AND BREATHING 

Anatomy. — The nostrils and mouth open into the 
upper part of the throat passage (pharynx). From the 
lower end of the throat the fleshy gullet leads to the stomach 
and the gristly windpipe (trachea) leads to the lungs. 
The windpipe is in front of the gullet ; it begins as the 
voice box (larynx), the gristly front of which you can 

feel as the Adam's 
apple. Rings of gristle 
or cartilage (feel them) 
have the very impor- 
tant duty (why impor- 
tant?) of keeping the 
windpipe open. About 
e four inches below the 
voice box the windpipe 
divides into two tubes, 

The right lung (3 lobes) and left lung (2 lobes). 
The space between them held the heart, large arter- the bronchi. One bron- 
ies and veins, windpipe, and bronchi. . , , 

chus enters each lung 
(see figure on this page) and then divides and subdivides 
again and again ; the smallest tubes end in clusters of tiny 
air chambers with thin walls surrounded by a network of 
capillaries. See figure on next page. 

The windpipe can be felt to enter the chest (or thorax) 
behind the top of the breastbone (feel it). The chest is 
a cone, its walls are of muscle and bone (ribs, breastbone, 

332 





THE LUNGS AND BREATHING 333 

backbone). The floor of the chest is a sheet of thin tendon 
and muscle called the midrifi, or diaphragm (see figure, 
page 334), which also forms the roof of the abdomen. It 
rounds up into the chest somewhat like two low domes 
(see same figure). Under the right dome is the liver 
and under the left is the spleen and stomach. 

The two lungs hang freely in the chest. Being attached 
only where the windpipe and large blood tubes enter them, 
they are free to move as the chest expands. 
To insure still better against painful fric- 
tion there is a double lining (the pleura) 
between lungs and chest. 

Physiology. — The work of the lungs is 
to supply oxygen and rid the body of 
carbon dioxid. As the thorax expands, air J^^t^^tiz 
rushes in, stretches the lungs, and makes tubes in lungs, 
them fill the enlarged space. This inbreathing is called in- 
spiration. The thorax expands because the muscles con- 
tract, lifting the ribs and swinging them out, and the 
muscular diaphragm flattens and sinks. Thus the thorax 
becomes broader and longer. When the muscles relax, the 
chest walls sink, the stretched lungs draw together, and out- 
breathing or expiration occurs. There is a short pause or 
rest before the next inspiration. (Watch yourself during 
several breaths.) Expiration may continue beyond the 
position of rest by forcibly drawing the chest walls down 
and in and by forcing the diaphragm up. A thin sheet 
like the diaphragm cannot force itself up, but the muscles 
forming the front and side walls of the abdomen draw in 
and press up the abdominal organs against the diaphragm. 
This presses the air out. (Try it.) 

The expired air contains less oxygen and more carbon 



334 



THE PEOPLES HEALTH 



dioxid than the inspired air. It also contains more of 
the vapor of water. (For proof of this, breathe against a 
cold window pane.) 

The blood as it passes through the capillaries in various 
parts of the body takes up carbon dioxid from the tissues 
and gives up oxygen to them. 

There is a constant flow of oxygen into and carbon dioxid 
away from the tissues because oxygen is continually unit- 
ing with carbon in the cells and forming carbon dioxid. 
The carbon used up in the cells is replaced by the foodstuffs 

eaten. A compound of iron 
(hemoglobin) in the red 
cells absorbs oxygen as the 
blood passes through the 
capillaries of the lungs ; the 
blood becomes a brighter red 
and carries the oxygen to 

Diaphragm. Lower portion of chest *-ne tissues, 
with parts of ribs cut away to show the When we breathe tOO 
dome-like diaphragm (of red muscle, except 

in the middle where it is white tendon). slowly there is a feeling of 

air hunger and we reflexly heave a sigh or a yawn. If the 
tissues can not get rid of carbon dioxid fast enough, as 
during rapid exercise, panting and a feeling of breathless- 
ness come on. 

Hygiene. — The throat is the crossroads from mouth, 
nose, ears, lungs, and stomach. — 

A tonsil is on guard on each side of the throat behind 
the mouth to halt dirt and germs. The adenoid is a smaller 
tonsil further back. See figure on page 208. (Draw it 
on blackboard.) Tonsils and adenoid are a growth of 
round lymph cells in connective tissue. They enlarge 
because dirty air or unclean mouth and nose give them 




THE LUNGS AND BREATHING 



335 






more work to do. If the air and nose are kept clean and 
the air cool and moist, they would not swell. A tonsil 
should not be removed merely because it is enlarged unless 
there is pus formed in it. A small diseased tonsil may be 
more in need of treatment or removal than a large one. 
Diseased tonsils may be cleaned and squeezed and kneaded. 
A tonsil may be so badly dis- 
eased that instead of killing 
germs it may be a gateway of 
germs for acute rheumatism 
and other diseases. Decayed 
teeth, raw spots on the gums 
or in nose, may also admit in- 
fection to the blood. 

The lungs must be free to 
work and they must be stimu- 
lated by vigorous exercise, 
without which we seldom draw 
a deep breath. The air breathed 
must be pure, moving, cool, and 
not too dry nor too moist. 
fectly still air is " dead." The 
race led an outdoor life for 
ages, and the nerves need the accustomed natural stimulus 
of moving, cool air. Those deprived of it become weak ; no 
wonder they feel depressed and seek an artificial stimulus. 

Ventilation should be so arranged as to keep the air 
moving, pleasantly cool and comfortably moist, as well as 
pure. Because of the moisture from many lungs and 
the heat from' many bodies, the air of schools, churches, 
and other assembly rooms may become too moist and too 
warm. On the contrary, the air of dwellings is usually 




Muscles of Neck, Shoulders, and 
Per;- Back. These muscles, if strong, pre- 
vent humpback ; they lift the shoulders . 
up and lessen the weight upon the chest 
and lungs. 



336 THE PEOPLE'S HEALTH 

too dry. Mustiness of rooms closed for several weeks is 
caused by a growth of molds. 

A person exercising actively vitiates the air about five 
times as fast as a person at rest. A room becomes un- 
pleasantly stuffy when the carbon dioxid has reached one 
per cent. This stuffiness is believed to be due to animal 
particles from the skin, lungs, and digestive tube which 
poison us, give rise to headaches and sleepiness, and 
lower the vital resistance to infection. 

Germs in many theaters and churches are warmed up and served 
fresh night after night or Sunday after Sunday. Delicate children 
who enter overheated and poorly ventilated schools risk their health. 
Even the strongest may be weakened. If children are dressed es- 
pecially for warmth, cheesecloth (not white because of glare) may be 
tacked over frames of right size and set into the windows of school- 
rooms to keep out rain, snow, and strong winds. Open-window 
schools, if the pupils dress warm, have many of the advantages of 
outdoor schools. A city was forced to build some temporary wooden 
schoolrooms beside the large brick schoolhouses. The pupils in the 
wooden houses had better health and did better work than those 
in the brick houses. 

Gardeners and clergymen have the best chance for a long life be- 
cause of much time spent out of doors. The two greatest Americans, 
Washington and Lincoln, were both ' surveyors in youth and early 
manhood and lived an outdoor life. Farmers should live longer 
than professional men, but they do not live as long. This is because 
they work 16 hours a day during the crop season and have anxieties 
for crop failures when the weather is not right. A farmer who goes 
in debt will not probably have as sound nerves nor live as long as one 
who tries to raise everything he needs at home, sells and buys as little 
as possible in town, and keeps out of debt. 

Applications. — (i) With a 36-inch tape measure the teacher may 
measure the circumference of the chest when most expanded and 
most contracted; difference of two measurements is called chest 
expansion. Find which pupil of each sex has the largest chest ex- 
pansion in school. (2) Send several pupils outdoors to remain for 
ten minutes; let them come in and note whether the schoolroom 
smells stuffy to them. (3) If pupils become inattentive, increase the 



THE LUNGS AND BREATHING 337 

ventilation and note effect. (4) Have the pupils who sleep with open 
windows raise their hands. Compare the color of their faces with 
the color of those who sleep with closed windows. (5) How much 
chalk dust gets into your lungs daily? More than on the coat be- 
cause the lungs suck in air. Examine coats. (6) At home test 
whether clothing at chest gapes when unbuttoned and a full breath 
is drawn. If so, it is dangerously small. (7) Practice the move- 
ments of resuscitation upon volunteers (appendix). 

Test Questions. — Name three openings into the throat from 
above; two from below. What is the structure of the trachea? 
The lungs ? Describe the thorax. The diaphragm. What is the 
relation of the lungs and the chest wall? 

What is the function of the lungs? Describe how inbreathing 
and outbreathing are brought about. How does expired air differ 
from inspired air? Where does carbon dioxid enter the blood and 
leave it ? Where does oxygen enter the blood and leave it ? What is 
panting a sign of? 

What and where are the tonsils ? Adenoids ? What is the func- 
tion of tonsils? W T hy do they swell? When should a tonsil be 
removed? How may adenoid growths and mouth breathing cause 
each other? 

What condition do the lungs require to do good work ? Name the 
two best stimuli to deep breathing? What are the qualities of air 
which is suitable for breathing? Discuss indoor air. What is most 
likely to be wrong in the air of assembly rooms? Of dwellings? 
What is the cause of mustiness? Stuffiness? What arrangements 
may be made for an open-window school ? Who have the best chance 
for a long life ? Which boy in school has the greatest chest expan- 
sion ? Which girl ? How is stuffiness tested ? How many by test 
at home found chest free for full expansion in spite of clothing? 

What did you learn in Chapter II about fresh air ? Ventilation ? 
Tuberculosis as a house disease ? Why are water- and steam-heated 
houses so often the worst ventilated ? 



CHAPTER XXV 



THE DIGESTION 




Digestive Organs from the front, i, gul- 
let, leading into broad portion of stomach; 
2, stomach, its narrow portion opening into 
duodenum, 7 ; 8, 9, small intestine ; 9', junc- 
tion of small intestine with colon; 10, blind 
end of colon with 11, appendix; 12, 12', 12", 
ascending, transverse, and descending colon ; 
13, rectum. The S-shaped curve is midway 
between 12" and 13. The liver has been turned 
up to show the gall bladder, 6, in which bile is 
stored until needed. 3, spleen; 4, pancreas. 

338 



Anatomy. — The diges- 
tive tube is about thirty 
feet long. Its parts are : 
the mouth, gullet, stom- 
ach, small and large in- 
testine. Its walls are 
mainly unstriped muscle 
and it is lined through- 
out with mucous mem- 
brane. The mouth con- 
tains thirty-two teeth for 
dividing the food and 
receives the ducts of six 
glands which secrete 
saliva. The gullet is a 
tube nearly as large as 
the forefinger and nine 
inches long. 

The stomach (see figure 
on this page) lies cross- 
wise, like a bag lying on 
its side. The gullet 
enters it at about the 
center of the waist and 
the intestine leaves it at 






THE DIGESTION 



339 



the right side. It is about ten inches long, but draws 
together when empty. When rilled it has a diameter of 
about six inches. This is the largest expansion of the 
digestive tube ; in its walls are many small tubelike glands 
which secrete gastric juice. 

The small intestine (figure, page 338) is over twenty feet 
long and a little larger than the gullet. The opening 
into it from the stomach is usually closed, being guarded 
by a strong ringlike, or sphincter, muscle called the pylorus. 
The first loop of the small intestine is called the duode'num, 
and into this is the opening of the duct from the large 
glands called the pancreas and liver. The small intestine 
takes many turns and loops throughout its course of more 
than twenty feet. Just above the right groin it opens 
by a valve into the large intestine, or colon. See figure, 
page 340. 

The colon (figure, page 338) is about the size of the wrist, 
six feet in length, with regular bulges in its walls. It 
first goes up as the ascending colon nearly to the waist, 
crosses over to the left as the transverse colon ; the descend- 
ing colon then leads down to the S-shaped, or sigmoid, 
bend; the next and last part, the rectum, is short and 
straight. 

In the market you may have seen sold for food the 
stomach of a beef, which is called tripe, the pancreas, 
called sweetbread, and the liver ; the lining of the small 
intestines of hogs is also eaten when it is used to hold 
sausage. 

Physiology. — Foods as we take them will hardly dis- 
solve ; yet they will not pass across the wall of the food 
tube into the circulation unless changed so as to dissolve 
readily. This change, called digestion, is brought about 



340 THE PEOPLES HEALTH 

in the tube itself by the action of secretions from glands. 

These secretions, or cell juices, contain alkali or acid and 

substances called ferments that help to change the food. 

By ' digestion each foodstuff is broken up into simpler , more 

soluble substances. 

Ferments are very wonderful and mysterious particles ; 

they accomplish tasks wholly out of proportion to their 

size and quantity. It is due to 
a ferment in the yeast plant that 
a tiny quantity of yeast is able to 
raise a very large quantity of 
dough. A ferment produces 
changes without itself changing 
or being used up, for it does not 
supply energy for the change. It 
ui A is like a ladder which enables 

colon Showing appendix, which m men to pass oyer a wall 

may become inflamed if colon is J x 

not well trained. For training yet is unchanged. It is like gravel 

see footnotes, pages 108 and 343. . . . _ ... . . 

which keeps a soil from being 
tight and lets down air and water to plant roots, adding 
to the crop grown, yet the gravel does not change. 

The salivary glands are in the floor of the mouth and in 
the cheeks. The slimy saliva moistens the food and makes 
it slippery. It changes starch into malt sugar. Boiled 
starch is changed in a few seconds ; unboiled starch changes 
very slowly. Starch may also be malted by toasting 
bread or baking it to a brown crust. Saliva and mucus 
kill disease germs. 

When the food enters the stomach, rhythmic waves, or 
beats, of contraction begin ; the stomach beats only about 
one tenth as fast as the heart. (See X-ray pictures, page 
107.) The saliva, which is alkaline, continues to act for 




THE DIGESTION 341 

half an hour after the food reaches the stomach. By 
that time the gastric juice becomes strong enough to neu- 
tralize it ; for of course an acid and alkali cannot both act 
on the food at the same time ; they would neutralize each 
other. (See page 93, Exp. 2 and 3.) 

The gastric juice contains hydrochloric acid and a ferment 
called pepsin. The acid kills germs, dissolves mineral 
salts, and changes cane sugar into grape sugar. The pepsin, 
aided by the acid, breaks up protein into peptones. 

The pylorus (see figure on this page) opens for liquids. 
Water or other liquid taken with the meal is promptly 
sent by the rhythmic contractions into 
the intestine to be absorbed. The solid 
food moves around close to the walls of 
the stomach ; as it is gradually reduced 
to a half fluid called chyme it moves to 

J Pylorus, the gate be- 

the center and is passed into the duo- tween stomach and 

. . . . . . small intestine, D. 

denum by the pylorus from time to time. 

From two to four hours after the meal the stomach is 

empty. 

When the acid chyme passes the pylorus, the intestinal 
cells notify the pancreas to begin secreting. This message 
is brought to the pancreas not only by nerves but also by 
a hormone called secretin which the intestinal cells send to 
the pancreas in the bloodstream. 

The pancreas (figure, page 338) looks somewhat like a 
flattened banana, and is reddish yellow in color. It lies 
behind the lower border of the stomach. Its secretion, 
the pancreatic juice, contains three ferments: one changes 
starch to grape sugar, another changes proteid to peptones, 
and the third acts upon fats. Thus the digestion of starch, 
begun in the mouth, and the digestion of proteid, begun in 




342 THE PEOPLE'S HEALTH 

the stomach, are completed in the small intestine. 1 The 
protein envelopes of the fat cells were digested in the 
stomach and fat globules set free. Fat globules are digested 
in the small intestine, being divided into fine particles to 
form an emulsion. The fat in milk, before it collects 
as cream, is an emulsion and makes the milk white. 

There are many small tabular intestinal glands in the 
mucous layer lining the small intestine ; their secretion, 
the intestinal juice, contains a ferment which changes 
cane sugar and malt sugar to grape sugar, the only kind of 
sugar which can enter the blood. 

The bile duct and pancreatic duct unite and enter the 
duodenum by a common duct. The liver is the largest 
gland in the body and it secretes a large quantity of bile 
which it makes from worn-out red cells of the blood. What 
is the bile for ? This greenish yellow liquid doubles the 
power of the pancreatic juice to digest starch and proteid 
and trebles its power to digest fat. After the bile has done 
its work its salts are carried by the blood back to the liver 
to be made into bile again. Bile salts excite the secretion 
of the liver ; calomel and other drugs do not. 

Summary of digestion: Mouth, for starch; stomach, 
proteid; small intestine, all; colon, none. 

There is no absorption from the mouth and very little 
from the stomach. Nearly all the absorption of food takes 
place from the small intestine. Its lining has many folds 
and fine velvety projections to increase the absorbing 
surface. 

The large intestine, or colon, is chiefly an excreting organ. 

1 In the intestinal wall and perhaps in the liver peptones are broken into 
still simpler substances called amino-acids ; in this form proteid food is 
carried to the tissue cells. 



THE DIGESTION 343 

The cells in its walls excrete lime, salts, iron, and phos- 
phates. A part of its contents consists of bacterial growth 
and indigestible parts of the food such as cellulose (woody 
fiber). 1 

The bean-shaped kidneys are against the back of the 
abdomen. From each kidney a white tube — the ureter 
— conducts its secretion to the bladder. This is a muscular 
bag lined with mucous membrane and lying in the pelvis 
(page 324). The kidneys purify the blood by filtering 
from it, mineral salts, urea, uric acid, water, and poisons. 

Hygiene. — You have already studied two chapters on the 
hygiene of food : " Pure Food " (page 74) ; " Food Values " 
(page 93). Most writers lay too much stress upon digestion. 
One who takes plenty of exercise, breathes fresh air, and 
eats pure food freely and regularly will not be troubled 
with indigestion. Beware of food faddists and diet cranks. 

1 This waste material collects in the sigmoid bend of the colon (figure, 
page 338) and once or twice a day rhythmic contractions carry it into the 
rectum. This gives a sense of fullness and uneasiness. This important 
instinct, or "call of Nature," should be promptly obeyed. If it is dis- 
regarded, the rectum soon relaxes and may become pouched and constipated. 
This is a condition which should be shunned by all refined and cleanly 
people. Metchnikoff holds that the growth of the colon bacillus (see page 
54) and other bacteria in a sluggish colon and the toxins they give off 
cause hardening of the arteries and old age. 

Foods that prevent constipation: Fibrous vegetables, green vegetables, 
fruits and potatoes eaten unpeeled, oily nuts (pecan, walnut), olive oil, 
dates, raisins, prunes, stone-rolled whole wheat, mush from the same flour, 
wheat bran (buy it at feed store) used in bread, breakfast food, pancakes, 
or puddings. Drink plenty of water. 

Constipating foods are: White bread and pastries, blackberries and rasp- 
berries, hard-boiled eggs, milk with meals. 

Foods -which tend to form gas, if eaten too freely, are : White bread and 
pastries, sugar except for sweetening, baked beans, sweet potatoes, white 
potatoes, except when baked, polished rice, tapioca, raw apples and grapes, 
meat if eaten three times a day. Remember there are exceptions in these 
lists differing for each individual. 

Signs of gas are: Belching, rumbling, palpitation of heart, colicky pains. 



344 



THE PEOPLE'S HEALTH 




One tells us to eat no salt, another says no meat, a third 
shuns sugar and starch. One eats no breakfast, the second 
no supper, the third eats one meal a day, the fourth eats 
six meals a day and between meals. One drinks no fluid 
at meals, another munches for an hour. One says eat 
everything raw, the next says eat everything cooked. 
One says eat very little, the latest crank 
says eat whatever you want whenever you 
want it. 

€ Avoid extremes. — No one way can be 

right for all. Each should follow the way 
that experience has shown to be best for 

Bread c 

f \ him. The Germans eat six times a day 

{■ J and tend to corpulence, yet one who eats 

Bak™i only twice a day tends to overload his 

^ Ik stomach. The city man is away from 

^■^P home at noon, he rightly eats dinner in the 

JI^ evening ; the country man is near home and 

( ^ ] has the advantage of eating the heavy meal 

^t/ at noon. 

Po tatoe s 

/ X Each country should prefer home-grown 

V k ) f 00 ^ b ecause °f its freshness. Arizona dates 

lMzZ are as fine as African dates and better than 

Nutrient fraction of the usual imported ones which have been 

six foods (black) . 

soaked in molasses. Solidified cottonseed oil 
is much prized abroad for making margarine, which is better 
than inferior butter sold in America at a higher price. 
Cottonseed meal is bright yellow, free from rancidity, and 
has a pleasant odor. It has twice the fuel value of eggs 
and one half more than beef or mutton. If it prove after 
refining and trial to be a healthful food for man, it would 
supply the place, not of bread, but of meat. A pound of 



THE DIGESTION 



345 



protein costs as cottonseed meal 5 cents; as beefsteak 
about 85 cents; as eggs about $1.06. 

With the protein of beans, peanuts, cowpeas, milk, or eggs 
at hand, none need suffer from pellagra because of a one-sided 
diet of carbon foods. Pellagrins can thus add protein to 
their diet as suggested by the United States Public Health 
Service. 

Applications. — 1. Let pupils hand in actual menus of 
their lunches or other meals, without signing them. The 
teacher and class will discuss them. 

2. About 2500 food units (calories) are needed daily. 
If, to balance the diet, ^ of the 2500 should be sugar or 
starch, t 3 q- fat, and ^ protein, how many units of each kind 
are needed? Select three meals for one day (2500 units) 
from the following list, with the food units after each food 
(see also lists on pages 96, 99) and bring the menu to class. 
To balance your ration roughly, select one proteid food 
(lean bacon, peanuts, cheese, steak, chops, eggs) for each 
meal and about half as much of fat as of sugar and starch 
(carbohydrate) ; but consult your taste as well. Water 
and salt are to be used, but are not on the list with calories, 
for neither will burn even if put into a fire. 

Bread (i oz.), i slice, 80 Round steak, \ lb., 200 Cheese, 1 oz., 120 

Corn bread, 1 oz., 80 Potato, usual size, 140 Sugar, heaped teaspoon, 40 

Lean bacon, 1 slice, 80 Sweet potato, usual size, 200 Butter, 1 inch cube, 40 

Peanuts, 1 oz., 150 Milk, \ pint, 140 Egg, 70; Banana, 50 

One pork chop, I lb., 150 Buttermilk, \ pint, 100 Apple, 60; Orange, 50 

3. Have the pupils examine labels on packages in pan- 
tries and kitchens, bottles, tin cans, pasteboard boxes, 
wrappers. Collect and bring to school all labels containing 
the words : artificially colored or flavored, coal-tar preserva- 
tive, salicylic, sulphite, borax, alum, etc. (See page 74.) 
Look especially for small, dim print. 



346 THE PEOPLE'S HEALTH 

He who weakens his digestion by selecting only the most digestible 
foods will be made sick when those foods are not within reach. One 
who eats only soft foods or foods from which mineral salts have been 
removed by milling (page 104) or boiling will have unsound teeth; 
and cleaning them three times a day will not keep them sound. The 
greatest need of the modern table is something to chew. Bread 
made without hog grease (water bread) is tough ; it gives the teeth 
something to do, nor does it become stale quickly. Since lard hinders 
the action of saliva upon starch, water bread is more nourishing than 
shortened bread. One raw food should be eaten at each meal. 

Those who eat too fast eat too much; those who munch too long or 
worry with diet foods do not eat enough. In cases of chronic invalidism 
the patient must be encouraged to eat. In acute illness the wise physician 
usually finds it best to give no food for a week or more except plenty of water. 
A fever patient loses by lungs, skin, and kidneys 4 or 5 quarts instead of the 
usual 3 quarts of water a day. Water washes out the toxins. 

Foods have degrees of digestibility: (1) Liquid foods are most quickly 
digested ; (2) next come foods that liquify at body temperature ; (3) those 
already broken into fine particles — as mashed potatoes, baked potatoes, 
crumbs, pieces of vegetables, nut butters ; (4) those easily broken up — as 
boiled potatoes, bread ; (5) those somewhat harder to divide — as meats, 
raw fruits ; (6) those toughest of all or with most refuse fiber — as fat 
meats, salads, raw vegetables, hard-boiled eggs, cheese. He who has good 
teeth and uses them will change the order of digestibility of some of these 
foods. 

Test Questions. — Digestive tube ; its parts, length, walls, 
lining? What is said of the mouth? Gullet? Stomach (size, 
position, glands) ? Small intestine (dimensions, pylorus, duodenum, 
pancreas) ? Liver ? Colon (size, structure, function) ? Define di- 
gestion ; ferment. Give location of salivary glands. Effect of saliva ? 
Changes that take place while food is in stomach ? In small in- 
testine ? Name the secretions in stomach and small intestine and 
their effects. Describe action of pylorus. Describe digestion of 
fat. What is the bile ? Its use ? Where is the food absorbed ? 

Name some food fads. What is said of time for dinner? The 
number of meals ? Arizona dates ? Cottonseed oil and meal ? How 
many calories of food are needed daily ? What proportion of the three 
foodstuffs is needed? Have you made out a menu totalling about 
2500 food units? Is food taken during illness? What two warnings 
are added? Discuss chewing. Water bread. Name six classes of 
foods according to digestibility. 



CHAPTER XXVI 
THE SKIN 

The skin protects, purines, and cools the body. It has 
tii'o layers, the epidermis, or outer skin, and the dermis, or 
true skin. The epidermis is a sheet of epithelial cells 
and would soon go to pieces but for the fibrous dermis 
supporting it ; the dermis would soon dry out but for the 
scaly mat of epidermis covering it. 

The lowest cells of the epidermis contain pigment (see 
first figure on page 291) which gives complexion and color. 
The deep cells of the epidermis are young and round (see 
same figure) ; they multiply and displace the older cells 
outward. When the cells reach the surface, they are dry 
and flat. The epidermis is epithelial tissue. 

Some cells of the epidermis grow down into the dermis 
and form pits from which the hairs grow. The hairs 
lessen the heat loss and help the nerves of feeling in the 
dermis. The epidermis and hair are made supple and 
partly protected from drying out by an oily secretion. 
This is supplied by oil glands with mouths opening into the 
hair pits. See figure on next page. The skin oil also 
protects against infection since it covers the skin and does 
not nourish germs. Too much oil in the scalp holds the 
scaly cells together in flakes and they are shed as dandruff. 
Sometimes in a warm bath the epidermis is rubbed off in 
rolls. Great heat may raise the epidermis in a blister, 
with lymph beneath. A blow also may do this and break 

347 



348 



THE PEOPLE'S HEALTH 



capillaries so that the blood leaks in and forms a blood 
blister. 

The soles and palms are without hairs ; hence they are 
also without oil glands ; but their sweat glands are espe- 
cially numerous. A sweat gland is a simple tube lying 
coiled in the dermis (see figure on this page) ; after a spiral 
course it reaches the surface as a pore. These glands 
regulate the heat of the body and remove impurities. 

Perspiration is usually 
insensible, but at times 
it collects in drops. 

That the bulk of the 
dermis is connective tissue 
may be known from the 
fact that leather is the 
connective tissue of an 
animal's hide from 
which the epidermis, 
nerves, and blood vessels 
have been removed by 
tanning. The dermis 
projects in hillocks into 
the epidermis. Each hillock, or papilla, contains a nerve 
ending or the loop of a capillary. On the palm where they 
are in rows, you notice they raise the epidermis and distinct 
ridges. A wart is rough because it consists of several papillae 
grown through the epidermis. 

The skin absorbs. Wash your hands with strong soap. 
as soon as you come home if you have touched poison ivy, 
to remove the poisonous oil before it soaks in. If not, 
you may have to use a wash made of sugar of lead. 

Hygiene. — A healthy complexion is indispensable to 




Section of Skin (for blackboard), a, b, 
epidermis (a, dry cells, b, soft round cells) ; c, 
dermis ; /, loop of capillary in a papilla ; e, nerve 
ending in papilla ; i, sweat gland ; m, oil gland 
opening into hair pit ; g, g, nerve fibers ; h, h, 
capillaries ; d, d, fat cells. 



THE SKIN 349 

good looks. This is because the race is instinctively 
attracted by tokens of good health and repelled by signs 
of bad health. The quality of the complexion depends 
largely upon the manner in which the lungs, stomach, liver, 
brain, nerves, and blood are treated and the way in which 
they do their work. But many act as if they think the 
skin of the face is independent of the rest of the body. 
See picture on next page. 

A weak, unsound skin is not resistant to infection. Pus germs and 
other germs reach the hair pits and oil glands, multiply, and cause 
pimples. To become free of pimples live wholesomely, keep the face 
clean by thorough washing with soap and tepid water ; rinse the soap 
off and finish with cold water. Never touch the face with the fingers 
at other times unless they have just been washed. Some boys and 
girls have pimples (acne) at the age of fastest growth because the 
nourishment cannot quite keep pace with the growth. Overeating 
of course would not help, for this would not increase but interfere 
with the powers of digestion. Never use soap strong enough to make 
the tongue smart if you taste it. 

A sallow skin may be made fresh and rosy by outdoor activities, 
sleeping with open windows, eating more fresh vegetables and fruit 
and less meat, and shunning overheated rooms. 

Regulation of the temperature of the body is the most 
important duty of the skin. All of the heat loss of the 
body takes place by the skin except the heat carried off 
in warm breath and bodily wastes. The skin loses heat 
by contact with the air and cold objects, and it gives up 
heat to change perspiration from its liquid state into water 
vapor. This takes up as much heat as is required to boil 
away an equal amount of water on the stove. The bodily 
temperature is controlled not so much by regulating the 
heat production in muscles, liver, and other heat-making 
organs as by regulating the perspiration and the amount 
of blood in the skin. 



350 THE PEOPLES HEALTH 

Clothing helps to protect from heat loss because air is 
a poor conductor of heat ; air is inclosed in the meshes of 
the fabric and between the layers of clothing. Wet cloth- 
ing does not prevent but aids the passage of heat from the 
body. We should dress for indoor temperature. Since 
this is nearly as high in winter as in summer, cotton is most 
suitable for undergarments. It is then easy to change the 
outer garments or add to them when going out, according 
.^^^^^..^^^^ to the severity of 

/ _> \ "*\ ^1 \ the weather. The 

\\ body's heat regu- 
^^\ Jt| lating power is 

limited. This we 
might conclude 
from the constant 
\ „^ / talk about the 

The Complexion and the Red Blood Cells : weather. 
These tiny hollow disks are very tender and easily in- ™, , , .,. 

jured by heat, cold, drugs, or chemicals. If broken, their J- ^ e OOdy Will 

red stuff and other life stuff pours out into the plasma hprnwp fl -hctOY 

and the empty " shadow cells" float on to the blood * 

filter, or spleen. If much stuff is set free, it makes the heat-maker and 
skin sallow, bluish, or ashy; practically all headache 

remadies, coal-tar drugs, tablets, etc., discolor the com- heat-Saver II One 
plexion and destroy millions of good red cells. • i« • nppH 

lessly warm dwelling or wears heavy flannels. The condi- 
tion overtakes one who habitually hugs a stove or radiator, 
or sits over a hot-air register. He easily gets the shivers, 
has cold hands and feet, and cannot bear a draft. This 
preference of too great comfort to vigor will weaken his 
whole body. Daily cold baths, lighter clothing, a couple 
of hours daily in the open air, and sitting away from the 
stove will train him to become a better heat-maker. Which 
food makes most heat? (See last chapter.) 

Infants are poor heat-makers and should be carefully 



THE SKIX 351 

protected. Active children are good heat-makers unless 
overclothed and weakened by hothouse life. The skin, like 
any other part of the body, must be trained to work. Kind- 
ness, tenderness, and indulgence, more often than hardship, 
are the assassins of health and life. If you fear heat pros- 
tration in summer, give your skin a chance to work. If 
you would insure against pneumonia, train your skin with 
cool baths. If colds are about and you escape them, 
thank your skin. 

If your throat becomes tender because of high collars, 
dash cold water on it whenever you wash your face and 
cease to muffle it up. A cold air bath in the morning, dur- 
ing a few minutes of bedroom gymnastics, is invigorating. 
// your skin fails to react and glow after a cold water bath 
with vigorous rubbing, see that the bathroom is warmer 
next time or heat your body by rapid exercise before the 
bath. // inclined to be nervous, do not take cold baths, but 
take a cold shower or a dash of cold water for a few seconds 
at the end of warm baths. Why should a cold bath be long 
in summer and short in winter ? 

Cold feet may be due to the use of foot warmers or to obstructed 
circulation from tight shoes or garters, or to general inability to make 
heat ; or cold, sweaty feet may come from wearing rubbers when not 
walking ; the cells in the sweat glands degenerate and the skin re- 
laxes. Such feet should be washed in cold water morning and even- 
ing and rubbed until they are red and warm ; wear light, well-venti- 
lated shoes ; to exercise feet, rise and sink on the toes, repeating for 
five minutes ; become a good heat-maker in general. 

House air. — Cool air that has sufficient moisture will no longer 
have enough when it is heated and expanded without moisture being 
added to it. Therefore heated house air is generally too dry. Pass- 
ing tp and fro between such house air and the outdoor air is a great 
strain upon the cells of the mucous membrane. If the lining of any 
of the air passages becomes dried out, it cracks; frequent or chronic 
colds and catarrh may follow. Our mucous membranes were not 



352 THE PEOPLES HEALTH 

developed for furnace-heated houses. The only instances of in- 
jurious dampness indoors in heated buildings are: laundries, textile 
mills, and sometimes crowded assembly rooms. House temperature 
should be below 70 and humidity over 50. 

Dry air may crack the mucous membrane and cause chapped lips 
and colds, dry the scalp and increase baldness, dry the skin and cause 
winter itch, chapped hands, and bad complexions. Damp air adds 
to the sultriness of a summer day because the air being already filled 
with moisture cannot take more from the skin. A dry atmosphere 
cools the body by hastening evaporation. Dry air leads to a demand 
for -overheating because dry air at 70 6 feels as cold as normally humid 
air at 60 . 1 

1 For all systems of heating there are easy methods of humidifying the air. 
Fireplaces draw in outdoor air so plentifully that the air is humid enough. 

For stove heat, place a broad pan or vessel on the stove and keep water in 
it all the time. 

For hot-air heat, place a pail or deep pan in each register ; fill daily ; for 
wicks stand many thicknesses of newspapers in the pans and the thirsty 
air will drink there instead of from your skin or air passages ; or use cloth 
wicks, letting them hang from a pan down into the pipe. Water pans 
at the base of furnaces are useless. A curved trough or pan made to fit 
around the dome of the furnace, holding 15 gallons and filled daily, is 
another way to solve the problem. 

For hot-water heat, have long pans or trays made and set under radiators 
and insert wicks made of blotting paper or newspapers. 

For steam heat, have a stop cock fitted to a radiator in each room on the 
side at which steam enters ; let steam escape into the room. 

A gallon of water should evaporate in each room daily. You will not look 
so dried out or mummified when winter is over, will have had fewer colds, 
and will have paid fewer doctor's bills. 

Tests. — If air has to be heated to 70 to be comfortable, it is too dry. 
On very cold days, if no moisture is condensed on window panes, the air is 
too dry. 

Fortunately for the Gulf States and states on the Mexican border, simple 
methods of heating are best, and, whatever selling agents may say, any 
kind of furnace or central heating with its attendant risks to health is 
needless. 

Test Questions. — Why are both dermis and epidermis needed ? 
What is each made of? Is there a difference between the cells in 
the epidermis? Where is the root of a hair? What is the origin 
and use of the natural skin oil ? Explain dandruff ; blisters. 

Describe a sweat-gland. What makes up most of the dermis? 



THE SKIS 



353 



What is leather ? A papilla ? Where arc oil glands absent ? Explain 
the presence of lines in palms and soles. 

Why is a healthy skin essential to good looks? Upon what does 
a good complexion depend? What are causes of pimples? Sallow- 
ness? The cure ? What is the most important function of the skin? 
In what two ways does the skin give up heat? How is the heat loss 
increased? Diminished? What is the body's normal temperature? 
How does clothing keep us warm? Rule for amount of clothing. 
What material is most suitable for underwear? How does one be 
come a poor heat-maker and saver? How reform? Infants and 
children as heat -makers? Why needful to exercise the skin? What 
is to be done if the throat is delicate? Effect of cold-air baths? 
What three ways to aid reaction after a cold bath? Causes of cold 
feet ? Cure ? 

Why is heated house air liable to be too dry? Effect of too dry 
air on mucous membrane? Hair? Skin? Why does dry air feel 
cooler than moist air of same temperature? How is moisture added 
to air when heat is from stoves? Hot-air registers? Hot-water 
pipes ? Steam pipes ? How much water per room should evaporate 
daily ? Give two rough tests for proper humidity. What is said of 
heating houses in border states from Florida to California ? 




.83 1890 1900 1310 

ENGLAND AND WALTS \ 



| UNITED STATES (RXj \ 



Degenerative Diseases. Combined death rate (per 10,000 pop.) from 
apoplexy, paralysis, and diseases of the kidneys, heart, and circulatory system. 
Note that the rate has nearly doubled in the U. S. Registration area within 30 years. 
Those saved from infectious diseases by public hygiene died of degeneration from 
lack of personal hygiene. 



2 A 



CHAPTER XXVII 

THE SENSES 

The muscular sense comes from sensory fibers in the 
muscles. It allows us with our eyes closed to know the 
position of our limbs. By means of this sense the muscles 
and nerves of a baseball pitcher cooperate to put the ball 
over the plate. 

The sense of touch reports changes of pressure and tem- 
perature in the skin. There are special fibers for heat, 
for cold, and for pressure. When a sharp point is pressed 
on the skin, the pressure becomes painful just before it is 
strong enough to pierce the skin. 

The nerve endings for taste are in the papillae of the 
tongue. Notice the tongue has a velvety look because of 
its many papillae. Sour and sweet tastes are reported 
by the edges of the tongue, salty and bitter 
tastes by the b>ack of the tongue. 

The nerve endings for smell are spread 
over the upper part of the nasal chambers. 
We sniff to draw the odor higher in the nose. 
We smell gases only ; solids and liquids do 

The nerve of smell. 

not affect the nerve of smell. Flavors reside 
in odors ; foods lose their flavor but not their taste when 
there is a severe cold in the head. 

Hearing. — In the wrinkled cartilage called the ear 
you notice the opening of a canal. This leads to the 
drumskin (commonly called the " eardrum") which sepa- 

354 





THE SENSES 355 

rates the outer ear from the drum chamber or middle ear. 

There is a tube leading from the throat into the drum 

chamber which keeps the air pressure equal on both sides 

of the drumskin. Artillerymen hold the mouth open 

when they fire a cannon. Why? Sound waves set the 

drumskin to quivering. Three tiny bones, the hammer, 

anvil, and stirrup (see picture on this page), carry the 

sound from the drumskin across the 

middle ear to the labyrinth, or inner 

ear. There it reaches the ends of the 

auditory nerve. The inner ear is filled 

with fluid. It also contains the nerve 

endings of the balancing sense whose 

nerve fibers go to the brain in the audi- The three bondets of 

the middle ear. 

tory nerve. When you whirl for several 

minutes and stir up the liquid of the labyrinth, what 

happens to the balancing sense ? 

Sight. — The eyeballs are in deep, bony sockets. The 
optic nerve and other nerves pass to the brain through holes 
in the walls of the sockets. The lids and tears are perfect 
dust removers ; the lashes are eye shades. You will see 
from the figure on this page and by studying your own eye 
that the eye is much like a camera. The curtain or iris 
adjusts the round window or pupil to the amount of light ; 
the lens is just behind it and throws the images on the 
rear wall. Copy the figure in your notebook or on the 
blackboard and write the names of each part. 

The two humors fill the ball and keep it round. The 
sclerotic coat, or white of the eye, makes the eyeball tough 
and strong. Its transparent front is called the cornea. 
The choroid, or middle coat, absorbs light which may pass 
through the retina. The retinal coat contains the sensitive 



35 6 



THE PEOPLE'S HEALTH 



endings of the optic nerve. Twelve muscles have the 
important duty of moving the eyeballs. 

Hygiene. — Squinting is due to lack of balance of the 
eye muscles. Squinters to prevent seeing double disregard 
the images in one eye, and it may become blind if not treated 
promptly with glasses. Sties are due to infection of the lid 
because of lowered vital resistance and lack of cleanliness. 
Astigmatism means that the lens is ill-shaped, the curva- 
ture not being equally strong all around. In farsightedness 

the eyeball is too 
shallow and the 
image falls be- 
yond the retina. 
In nearsightedness 
(myopia) the eye- 
ball is too deep 
and the image 
falls short. In 
both cases the 
image is blurred. 
These three de- 
Headaches following 




Re tin* 
loroid 
Xerotic coat 

Diagram of the Eyeball (for blackboard). 



fects can be corrected by glasses, 
study indicate astigmatism. 

If your eyes feel gritty, winky, watery, or achy, look to 
your light. It should not be too dim nor too bright, and 
above all it should not flicker. Do not sit near moving 
picture screens, do not look at flickering pictures. Light 
that comes from the front or from low down is very trying. 
Nearsighted pupils should have front seats. A blackboard 
should not be placed between windows. Windows of school- 
houses should, according to the site, take up one fourth to 
one sixth of the wall space. 



THE SENSES 357 

Nearsightedness is caused and made worse by bending 
the head over the work. This makes the eye adjust itself 
for short distance ; and, still worse, it makes the blood 
congest in the eye. If the desk has not a slope of 40 , 
the hand holds up the book but soon gets tired ; the book 
lies flat on the desk, the spine is bent, the head drops, and 
the eyes are injured. See pictures, page 213. 

Weak eyes are due to use when weak from illness, bad 
Ugh ting, print or work too fine, and above all to bad habits 
of posture, as just explained. 

The normal ear should hear a watch tick several feet 
away and a whisper 18 or 20 feet. Test it, trying each ear 
separately. You learned that the throat is the meeting 
place for many roads. (Which?) The tube that leads 
from it to the middle ear, or drum chamber, may be closed 
by a chronic cold and inflammation and the ear on that 
side may become deaf. Earache may be caused by risings 
in the outer canal or in the drum chamber. Never use 
laudanum to relieve it if you value your hearing; a bag 
of hot salt will probably serve the purpose. Blowing the 
nose very forcibly may injure the drumskin. A cold that 
settles in the middle ear may stiffen the hinge joints between 
the three bonelets. This may cause whispering sounds and 
even deafness. 

Every noise gives a nervous shock like the blow of a tiny 
hammer disturbing the cerebral mass. Railway mail 
clerks, typewriters, printers, show symptoms of chronic 
fatigue because they work under tension and heightened 
blood pressure due to the shocks from noise. A depression 
comes when reaction sets in. As the eyes need rest, so the 
ears need silence. Most people who live in the noisy parts 
of cities are in a state of constant nervous fatigue and unfit 



358 THE PEOPLE'S HEALTH 

for sustained effort. Just as some people come to dislike 
fresh air, others learn to like noise ; either is a proof of an 
abnormal condition. 

Test Questions. — Where do the fibers end that report the 
muscular sense ? 

Name the special senses. When is pain felt in the skin? What 
is said of the sense of taste? The sense of smell? How far in does 
the outer ear extend? What is the middle ear? How is the air 
pressure kept equal in outer and middle ear? What is the function 
of the bonelets ? Where are the endings of the nerve for balancing ? 
Its fibers are bound up with what nerve? 

Locate and give the use of : orbits, lids, tears, lashes, iris, pupil, 
lens, aqueous and vitreous humors, sclerotic coat, cornea, choroid 
coat, retina, optic nerve. 

State the facts which control the hygiene of squinting, sties, 
astigmatism, farsightedness, nearsightedness, lighting, and posture 
in relation to the eyes. 

Why are textbooks with large, clear pictures more desirable than 
those with small pictures or none at all ? 

What is a test for normal hearing? What two results from colds 
in the head may lead to deafness? Explain earaches. What injury 
may result from blowing the nose too forcibly? Explain fully how 
habitual noise is an injury. 






APPENDIX 









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2fy permission of the University of Wisconsin. 
Exercises for strengthening the walls of the abdomen (see appendix). 



360 



APPENDIX 

PREVENTION OF ACCIDENTS; EXERCISES FOR PRACTICE IN FIRST AID 




Fig. i 

As in all matters concerning health, so with accidents, prevention 
is better than cure. Preventable diseases number one half, but pre- 
ventable accidents number two thirds of all. 

Poisons should be labeled with skull and crossbones and placed 
out of reach (Fig. 2). (Obtain labels from any druggist.) 

Bums. Children should not stand near open fire in chimney or 
field, as the draft may draw the skirt or clothing into it. In case of 
burns, apply common soda in a thin paste twice a day. 

How to Avoid Street Accidents 

Do not cross streets except at crossing. You have right of way 
there, but nowhere else. Look both ways before starting ; do not 
turn back, as hesitation will confuse drivers. 

In using a knife, cut from, not towards, your face. In case of a cut 
artery, press it on the side nearer the heart (Fig. 7). Figure 1 1 shows 

361 



362 



APPENDIX 





tourniquet on the leg. Practice on 
the arm. Find artery near the arm- 
pit or in the wrist by its throbbing. 
Make tourniquet with a handker- 
chief, and use a smooth stone over 
artery. Do a cut up in the blood. 
Blood is a good antiseptic and salve. 



Carrying the Injured 

Let one boy lie on the ground ; three others stand 
side by side, slipping their hands under him and lifting 
together at word of command (Fig. 13.) All of the 
methods here illustrated should be practiced in class. 
Fireman's lift (Fig. 3). Two-man carry for helpless 
(Fig. 4). Chair-carry with chair (Fig. 5). Chair-carry without 
chair (Fig. 6 and page 302). Chair-carry with support to back (Fig. 
14). Three-man carry (Fig. 13). 

Giving way of abdominal wall beneath the skin (rupture, or 
hernia) is very common. It is believed to occur with five out of 
a hundred men and boys. It is difficult for surgeons to remedy even 
with an operation, for it only occurs when the wall is thin and weak. 
Sometimes a loop of the intestine is pushed under the skin and may 
become strangulated, threatening death. In this case lift the boy 
by his feet (Fig. 12) and hold him a few seconds with the head down, 
and the loop will return to its place. It is important to practice 
exercises to develop the wall of the abdomen. Two of these (figures 
loaned by University of Wisconsin) are shown on a preceding page. 
A pillow may be kicked instead of a football. Instead of raising the 
legs, the legs may be held down, while the person rises to the sitting 
posture twenty times. The feet may be held while the person lying 
on his back tries to kick his feet free. All such exercises strengthen 
the walls of the abdomen and prevent this disabling accident. 

To sterilize a knife or needle for picking out a splinter. See Fig. 9. 

To make a sling for broken arm with a triangular bandage. Fig. 8. 

To bind up a deep cut in the palm (Fig. 10). Place in the middle 

of the palm a pad of sterilized cotton which the patient is to grasp 

tightly. With a bandage bind the fingers firmly over the pad, passing 

the bandage round the hand and wrist. 

Peroxide of hydrogen is best for sterilizing wounds and sores. It 
becomes useless if it is very old. Foaming is a sign that it has not 
lost its strength and that it has found work to do. 




Fig. 8. 



Fig. 14. Chair-carry with support 
to back. 



*6i 



364 



APPENDIX 




First Position 



Second Position 



Resuscitation 

Let every pupil in class practice this important exercise so he 
will not hesitate if he ever need to use it. Lay the patient face 
down, the face a little to one side. Place hands as shown in Position 
1, with thumbs extended toward each other. Lean forward and 
put the weight of your body straight over the lower ribs (Position 2) 
and count three slowly. For two seconds release pressure (Position 
1 ) by squatting backward. Alternate thus about 12 times a minute 
until breathing is restored. 




WE WILL NEVER DESERT A SUF- 
FERING COMRADE." (Page 1.) 



INDEX 

Figures in italics refer to definitions. References include the illustrations and 
legends as well as the text. The index may be used as a guide for final review, one 
column for one lesson. It may also furnish subjects for essays and guide in writing 
them; examples: White Blood Cells, Citizens (and health), Woman's Health, Death 
Rates, Dust, Factories (and health), Resistance to Disease, Clothing, Schools (and 
health) . 



Absorption, 342. 

Accidents, 269, 272, 361. 

Acetanelid, 174, 310. 

Acids, 93, 341 . 

Acute disease, 11, 346. 

Adenoids, 4, 207, 208, 328, 334. 

Adrenalin, 304. 

Adrenals, 303, 304. 

Adulteration of food, 74-83. 

Alcohol, 157, 167, 169, 171, 172, 282, 286, 

287, 288, 309, 326. 
Alkaline, 93, 312, 340. 
Ameba, 293, 294. 
Amino-acids, 342. 
Anemia, 317. 

Anopheles, 132, 134, 144, 148. 
Antagonist muscles, 319. 
Antitoxin, 16, 117, 126, 129, 287, 288. 
Appendicitis, 340. 
Appetite, 87, 106, 280. 
Apple, 97, 98, 99, 345- 
Applying for work, 272. 
Aqueduct sewer, 215. 
Arizona dates, 344. 
Army of U. S., 3, 53, 113, 143, 145. 
.Arteries, 313, 316; hardened, 285, 343. 
Asheville, 50, 210. 
Astigmatism, 192, 336. 
Athenian, 1, 32. 
Auricle, 3, 13. 

Babies, 6, 7, 58, 59, 67, 112, 168, 186, 189. 

Bacillus, 12, 13, 130. 

Bacteria, 12, 13, 48. 

Bakery, 103, 243. 

Balanced ration, 345. 

Balancing sense, 355. 

Baldness, 283, 350. 

Baltic blonde races, 39. 



Banana, 97, 345. 

Baseball, 154, 354. 

Bathing, 47, 50, 120, 125, 251, 320 326, 

35i- 
Beauty hints, humbug, 286. 
Bed bugs, 148. 
Beef, 98, 99, 345- 
Benzoate of soda, 78, 79, 83. 
Beriberi, 104, 310. 
Bile, 342. 
Binghamton, 51. 
Bladder, 343. 

Blind-alley work, 269, 274, 275. 
Blister, 314, 347. 
Blood, 9, 10, 312. 
Blood pressure, 304. 
Bony tissue, 296. 
Borax, 74. 

Boston, water supply, 44. 
Bread, 103, 242, 345; white, 102. 
Breathing, 157, .158, 160, 192, 207, 208, 

327. 
Buncombe Co., 210. 
Burns, 299. 
Butter, 70, 75, 345- 

Caloric, 96, 97, 301, 345. 

Campers, 33, 34, US- 

Campfire girls, 153, 295. 

Canal Zone, 131, 315. 

Cancer, 295. 

Cane sugar, 79, 105, 301, 319. 

Canned goods, 75, 76, 105, 310. 

Capillaries, 313, 314, 3*5- 

Carbohydrate, 345. 

Carbon, 298, 301, 309. 

Carbon dioxid, 20, 298, 314, 320, 333 

Carbon monoxid, 25. 

Carbonic acid, 299. 



365 



3 66 



INDEX 



Cartilage, 296, 324, 326, 328. 

Cellar, 14, 73, 91, 179. 

Cells, 8, 9, 10, 2Q3, 326; white blood, 9, 

n, 15, 16, 37, 125, 171, 278, 288, 291., 

302, 312. 
Cellulose, 342. 

Central nervous system, 307. 
Cerebellum, 306. 
Cerebrum, 306. 
Cesspool, 44, 47, 250. 
Cheese, 98, 345. 
Chicago, 198, 206. 
Chicken cholera, 15, 16. 
Chinese, 3, 100. 
Chinning, 156. 
Cholera, 217, 226. 
Christmas dinner, 100. 
Chronic disease, 11, 153, 228, 345. 
Chyme, 341. 
Cigarettes, 310, 316. 
Cigar makers, 268, 276. 
Circulation, 312. 
Cistern, 45, 252, 257. 
Citizen, 1, 7, 10, 76, 113, 139, 192, 289. 
City life, 232-244. 
Civilization, 153, 266. 
Clavicle, 325. 
Clean milk, 56-73, 84. 
Clot, 291, 304, 313. 
Clothing, 23, 26, 39, 155, 159, 197, 262, 

286, 317, 322, 327, 328, 329, 350. 
Coal foods, 95, 300, 301. 
Coal tar, 77, 79, 310, 346. 
Cocaine, 171, 309. 
Coccus, 12. 
Cold feet, 283, 351. 
Cold storage, 81, 82. 
Colds, 26, 34, 120, 121, 281, 330. 
Colon, 33Q, 342, 343. 
Colon bacillus, 54, 343. 
Color blindness, 191, 276. 
Complexion, 285. 317, 348, 350, 352. 
Condensed milk, 68, 100. 
Congress, U. S., 2. 
Connective tissue, 2q6, 348. 
Constipation, 57, 98, 108, 283, 343. 
Constrictor nerves, 308, 310. 
Consumption, 12, 26, 27, 120, 172, 220, 

235, 249, 258. 271, 276. 
Contagious, 116. 
Cook, 5, 101, 180. 
Cooker, tireless, 177. 
Corns, 281. 

Corset, 322, 323, 328. 
Cortex, 306. 
Cot, 20, 21, 



Cotton, 26, 102, 350. 

Cottonseed meal, 344. 

Cottonseed oil, 102,' 344. 

Cough, 279, 330. 

Country school lunch, 201. 

Cow hygiene, 61. 

Croup, 117. 

Culex, 132, 134. 

Cup, drinking, 40, 60, 122, 127, 204. 

Curds, 58. 

Cuts (treatment of), 361. 

Dandruff, 283, 347. 

Death rate, 32, 218, 223, 228, 258, 353. 
Defectives, 194, 195. 
Defenses of body, 286, 287, 288, 291. 
Dentist, no, in, 112. 
Dermis, 347. 

Detention, periods of, 226. 
Dextrin, 81. 

Diaphragm, 156, 2>33, 334- 
Diarrhea, 59, 317. 
Diet, 99, 100, 345. 
Digestion, 163, 316, 339. 
Dilator nerve, 308. 

Diphtheria, 117, 203, 224, 225, 226, 230. 
Disease, 164, 228, 315, 345. 
Disinfect, 16, 47, 52, 182, 224, 231. 
Drains, 48, 239. 

Drinking cup, 40, 60, 122, 127, 203, 204. 
Droplet contagion, 31, 32, 149. 
Drug habit, 80, 171, 309. 
Drugs, 173, 283, 286, 309, 350. 
Duct, 2q6. 

Ductless gland, 303, 304, 305. 
Duodenum, 33Q, 341. 
Dust, us, 178, 181, 182, 183, 184, 185, 
203, 205, 236, 242, 269, 270, 274, 335. 
Dwarfs, 305. 

Earache, 357. 

Eardrum, 334, 357. 

Eggs, 75, 76, 81, 82, 95, 99, 345- 

Electric belt, 173. 

Emulsion, 342. 

Energy, 298, 300, 309, 317, 319. 

England, 23, 89, 151. 

Epidermis, 347. 

Epithelial tissue, 2q6, 347. 

Eugenics, 169, 170. 

Evans, Dr. W. A., quoted, 107. 

Excretion, 2q6. 

Exercise, 155, 160, 162, 163, 186, 193, 

322, 360. 
Experiments, n, 54, 56, 74, 75, 76, 93, 

94, 328, 329, 330, 336. 



IXDEX 



367 



Expiration, 333. 
Extensors. 319. 
Eyesight, 211. 213, 27S. 355. 

Factories. 155. 102. 250. 202. 205. ;- 

Fads. 2S2 ; diet fads. 344. 

Fainting. 316. 

Family chart. 169. 

Farmer. SS. 105, 17S, 247, 320, 330. 

Farmers* Bulletins. 96. 97. 9S, 244 

Farsight. 350. 

Fasting. 299. 

Fatigue. 101. 201. 2S0. 304, 320, 321. 

57 

Fats and oils, 94, 301. 342. 

Fatty tissue. 2q6. 300, 304. 

Feeble-minded, i6q. 

Ferment, 101. 340. 

Fever. 13S. 2 78, 346. 

Fibril. 31S. 

Fibrin, 313. 

Fig. dried. 97. 

Filter. 47. 4S. 51. 

Fish. Si. S9. 

Fisher. Professor Irving, 227 

Flat chest. 321. 32S, 329. 

Flat foot, 2S1. 

Flavor. 5 4 

Flea. 14S. 

Flexors. 319. 

Flies. 133. 145. 146. 147, 252. 

Florida Board of Health. 25. 52, 108. 

Food. 10. 74-1 1 3. 344. 

Fowls. 15. 70. Si. h 

Fresh air. 20-41. 

Fruit. 97. 317- 543- 349- 

Fuel values. q6, 99. 345. 

Fumes. 269. 

Fumigate, 140, 230. 

Function. S. 

Furnace heating. 24. 25. 04. 352. 

Furniture, 181. 

Gall bladder. 

Games, 159, 248. 

Ganglion, 306, 308. 

Garbage, 49. 1S2. 252. 

Gardeners, longest lived, 336. 

Gary. Ind.. 200. 

Gelatin. 4S. Si. 326. 

Georgia. 47, 240. 

Germs, n. 115. 125, 1S1, 230. 291, etc. 

Giants. 305. 

Gladstone, quoted. 293. 

Gland. 2g6; ductless. 313. 304. 305. 

Glass factory, 279. 



Glucose, 79, 105. 
Granular lids, 124. 
Grape sugar. 341. 342. 
Greeks. 2. 102. 327. 
Grip, 27. 121. 122. 126. 
Gullet, 332, 33S. 

Habit-forming drugs. 1 7 1 

Hair. 347. 

Handkerchief pocket. 32. 

Headaches. 2S3, 310. 322. 356. 

Health. 5, 11; public. 6. 

Health department, 217-231, 289. 

Health fads. 7. 2S4: diet fads, 344. 

Health officers, 170. 217. 220. 222. 

Hearing. 192, 193. 213, 354. 357. 

Heart. 155. 160. 30S. 

Heat regulation, 24. 191, 206. 241, 249, 

305- 
Heat stroke, 21, 276, 351. 
Heels. 322. 327. 
Heitmuller, Dr., 213. 
Hill, Leonard, Dr.. 20. 155. 
Hoag. Dr., 210. 
Hodge, Professor, 135. 15S. 
Holidays. 161. 
Home, 5, 177-190. 
Hookworm. 253-256. 320. 
Hormones, 303, 304. 305. 314, 341- 
Hotwater heating. 24. 352. 
Housekeeping. 157. 1S3-190. 
Humerus, 325. 
Humpback. 32S. 
Hurty. Dr., quoted. 249. 
Hygiene, 5 ; personal, 5, 7 ; public, 5, 8. 

Ice box, home made, 57. 67, 177. 

Ice cream. So. Si. S3. 

Iceless cooler, 17S, 25S. 

Immunity. 16, 37. 40. 287. 

Independence day, 12S, 129. 

Indian corn, 104. 151. 

Indiana Board of Health, S2, 147, 249. 

2$D. 251. 250. 

Indians, 124. 

Infantile paralysis. 14S-150. 

Infection, 4, 27, 115, 203. 

Infectious, //, 195, 226. 

Inflammation 

Influenza. 121, 122, 126. 

Inheritance, 16S, 269. 

Inhibit. 308. 

Insane, 168, 257. 

Inspectors, 70, 77, 94, 224. 

Instinct, ic6, 2S1. 349. 

Iowa Health Bulletin. 220. 248. 



3 68 



INDEX 



Iron, 301, 334. 
Isolation, 183, 224. 

Jacksonville, Fla., 52. 
Jams, 79, 114. 
Japanese, 54, 100. . 
Jenner, Dr., 16. 
Jews, 39. 
Joints, 324, 330. 

Kidneys, 123, 173, 304, 314. 322, 343. 
Kitchen, 179, 180. 
Kissing, 115, 119. 
Knopf, Dr., 23, 31. 

Labels, 82, 173. 

Lactic acid, 56. 

Larynx, 332. 

Lateral curvature, 162, 328, 329. 

Laundry, 30. 

Laveran, Dr., 138. 

Leper Colony, 18. 

Ligaments, 324, 330. 

Lime, 301, 326. 

Liquor dealers, 238, 262. 

Liver, 156, 342. 

Lockjaw, 127. 

Los Angeles, 47, 223. 

Louse, 149. 

Lungs, 155, 160, 332. 

Lupus, 27. 

Lymph, 10, 313, 314. 

Lymph glands, 37, 208, 291, 313. 

Lymphatics, 137, 314. 

Machinery guarded, 269, 270, 271, 272. 

Magnetic healer, 6. 

Malaria, 47, 139, 143, 230. 

Malnutrition, 94, 104, 201. 

Malt sugar, 340, 342. 

Mark Twain, 316. 

Markets, 86, 88, 243. 

Marriage, 169. 

Massachusetts, 211, 221. 

Measles, 123, 203, 226. 

Medical Inspection of Schools, 194, 206, 

207, 210. 
Medulla, 307, 308. 
Membrane, 297; mucous, 297, 339, 343, 

352. 
Meningitis, 126. 
Mental hygiene, 164, 311. 
Microscope, 8, 12. 
Milk, food value, 98, 99, 100; test of, 

56, 84. 
Milking pails, 64, 65, 68. 



Mineral foods, 95, 99, 109, 301, 346. 

Missouri food inspection, 61, 77. 

Mold, 182, 336. 

Morphine, 309. 

Mosquito bar, 139. 

Mosquitoes, 131, 132, 137, 138. 

Motor nerve, 306. 

Mouth, 338, 340. 

Mucus, 2Q7, 340. 

Muscles, 156, 318, 321. 

Muscular sense, 354. 

Mustiness, 336. 

Muzzles for dogs, 151. 

Narcotics, 170, 30Q. 

Nasal tones, 192. 

Nearsight, 356, 357- 

Negroes, 29, 238. 

Nerve center, 307. 

Nerve specialist, 311. 

Nerve tissue, 295. 

Nerves, 303, 305, 306, 321. 

Nervous system, 305. 

Nervousness, 164, 168, 174, 209, 210. 

310, 350: 
Neurasthenia, 310. 
Neuritis, 310. 
Neuron, 306. 
New York City, 6, 207, 273 ; schools, 4, 

50, 101, 104, 156, 193, 209, 285; state, 

219. 
Noise, 239, 357. 
Nose, 207, 213. 
Nucleus, 8, 2Q3, 315. 
Nuts, 98, 99, 343. 

Obsession, 311. 

Occupation, hygiene of, 274. 

Open air schools, 24, 197, 336. 

Open window schools, 336. 

Open stair house, 235, 238. 

Opsonin, 126, 294. 

Oregon school lunches, 201. 

Organ, 8, 10, 37. 

Oxidation, 2qq. 

Oxygen, 10, 127, 162, 299, 302, 309, 314. 

Oysters, 43, 51. 

Pancreas, 341. 

Papilla, 348. 

Parcel post, 88. 

Pasteur, ii, 15. 

Pasteur institutes, 52. 

Pasteurization, 56, 67, 68, 71. 

Patella, 325. 

Patent medicines, 6, 29, 172, 250, 257. 



IXDEX 



3 6 9 



Pelvis. 343. 

Pellagra. 150. 345 

Pepsin, 341. 

Peptones. 341. 

Peroxide, 128, 302. 

Pharynx, 322. 

Phila. High School luncheons, 199. 

Philippines. 287, 2S8. 

Phosphates. 103. 

Physical culture, 159, 322. 

Physician. 3. 4. 194, 203, 271, 275, 278. 

Physiology, 293. 

Pimples. 345. 

Pipeless stove, 25. 

Pituitary. 304. 305. 

Plague, 14, 148, 217. 

Plasma. 312. 

Playgrounds. 157, 165, 200, 217, 232, 275. 

Pleura, 333. 

Pneumococcus, 119, 126. 

Pneumonia, 40, 115, 119, 126, 271, 351. 

Poison ivy, 348. 

Porto Rico, 255. 287. 

Posture, 327. 32S, 330. 357- 

Poverty and consumption, 29. 

Prevention. 3. 4, 115, 133. 

Proteid or protein, 93, 95, 97, 103, 300, 

314, 341, 345- 
Pulse. 314; tobacco, 316. 
Pure food. 74, 92. 
Pure water, 42-55. 
Pus. 112, 123, 335. 349- 
Pylorus, 339, 34 1- 

Quack foods. 106. 

Quacks, 6. 

Quarantine, 224, 225, 226. 

Rabies, 151. 

Railroad frog, 276. 

Railway train toilets, 115. 

Raisins, 79. 

Recreation, 321. 

Rectum, 339. 

Red blood cells, 9, 25, 291, 312, 313. 350. 

Red bone marrow, 313. 

Reflex, 307. 

Resistance to disease, 14, 38, 124, 125, 

278, 286, 287, 289. 
Resuscitation, 364. 
Retina. 355. 

Rheumatism, 15, 265, 323, 335. 
Rifle shooting, 167. 
Rocky Mountain fever, 150. 
Ross, Dr., 138. 
Round shoulders, 321, 328. 



Rupture, 362. 

Rural sanitation, 245-260. 

Saccharine, 79. 

Safety in factories, 269, 272. 

Saliva, 340. 

Sandwich Islands, 18. 

San Francisco, 152, 223. 

Sanitary closet, 257. 

Sanitary districts, 258. 

Sanitary surveys, ix, 133, 217. 

Sanitation, 5, 39, 43, 153, etc. 

Savage man, 38, 100. 

Scarlatina, 115, 12 3. 

Scarlet fever, 115, 123, 183, 224, 225. 

School, desks, 212, 213, 329; doctor, 194, 

203, 206; grounds, 200, 201, 205; 

house, 197, 201, 202, 248, 356; lunches, 

198, 199, 201, 345; nurse, 194, 203; 

sanitation, 191-214; survey, ix. 
Screens, 143, 148, 215, 252. 
Scrofula, 27. 
Scurvy, 58. 
Secretion, 296. 
Senate, IT. S., 2. 
Sensory nerve, 306. 
Septic tank, 256, 257. 
Serum, 117, 291. 
Sewage, 43, 48. 
Sewer aqueduct, xiv. 
Sewers, 48, 51, 237, 238. 
Shoes, 281, 322. 
Shoulder bones, 325. 
Sitting out suit, 196. 
Skeleton, 324-331. 
Skin, 125, 203, 291, 347. 
Slavery and consumption. 29 ; and health, 

262. 
Sleep, 29, 31, 280, 282, 320. 
Sleeping car, 31. 
Sleeping porch, 32, 33, 185, 281. 
Slums, 219, 238, 256. 
Small intestine, 339, 341. 
Smallpox, 12, 115, 127, 226. 
Smell, 354. 
' Soap, test for, 349. 
Sorghum sirup, 105. 
Sour milk, 58. 
Spanish War, 3, 53, 145. 
Spinal cord, 307. 
Spine, 155, 162, 324, 328. 
Spirillum, 12. 
Spleen, 314, 322, 338. 
Sprains, 330. 
Springs, 45, 46. 
Sputum, 12, 30, 31. 



37° 



INDEX 



Squeegee, 242, 243. 

Squinting, 356. 

Starch, 93, 95, 97, 99, 104, 299, 345. 

Steam heating, 25, 185, 352. 

Sterilize, 17, 30, 32, 52, 61, 183, 226, 362. 

Sternum, 325. 

Stimulant, 170, 171, 308, 335. 

St. Louis milk supply, 61. 

Stomach, 338, 346. 

Stove, 25, 205, 206, 352. 

Street cars, 154, 155. 

Street cleaning, 236, 241, 242, 243. 

Stuffiness, 336. 

Suction fans, 270. 

Sugar, 95, 301, 319, 341. 

Sulphite, 82, 345. 

Sulphur, 72. 

Summer complaint, 59, 317. 

Sunlight, 16, 22, 27, 299, 310. 

Suspenders, 330. 

Sweat glands, 348. 

Sweatshops, 266, 269. 

Sweeping, 183, 186, 187, 205. 

Sympathetic system, 307, 308, 322. 

Symptom, 281 . 

Tapeworm, 320. 

Tarsus, 325. 

Taste, 354. 

Teeth, 94, 109-113, 210, 212. 

Temper and nerves, 168. 

Temperature of body, 299, 305, 349, 350 ; 

of house, 20, 23, 25, 351, 352. 
Tetanus, 127, 130, 190. 
Thigh bones, 325. 
Thorax, 325, 332. 
Thyroid, 304. 
Tissue, 10, 96, 295. 
Tobacco, 310, 316. 
Tone, muscular, 321, 322. 
Tonic, 310. 
Tonsil, 209, 334. 

Tooth brush, no, 346; pick, 112. 
Touch, 354. 
Towels, 204. 

Toxin, 15, 59, 117, 121, 126, 32c. 
Trachea, 332. 
Trachoma, 124. 
Train toilets, 115. 
Trichina, 83. 
Tuberculin, 61. 
Tuberculosis, 27-41, 59, 124, 196, 219, 

230, 249. 
Typhoid carrier, 50, 60, 62, 115., 
Typhoid fever, 43, 45, 46, 49-55. 59, 00, 

226, 248, 250, 251. 



Undernourishment, 94, 104, 201. 
Unstriped (involuntary) muscle, 318, 338. 
Ureas, 343. 
Ureter, 343. 
Uric acid, 343. 

Vaccinate, 16, 53, 118, 127, 230. 

Valves, 314. 

Vanilla extract, 75, 79. 

Vapor bath, 282. 

Vasomotor nerves, 308. 

Vegetables, 86; 90, 108, no. 

Veins, 313, 314, 315. 

Ventilation, 20, 23, 26, 335, 336. 

Ventricle, 315. 

Vermiform appendix, 340. 

Vertebra, 324. 

Vinegar, 75, 79. 

Virginia Health Bulletin, 48, 122, 137 

185, 225, 227. 
Virus (disease germs or toxin), 16. 
Vital knot, 307. 
Vital statistics, 222, 228. 
Voice box, 332. 

Voluntary movement, 307; muscle, 318 
Vomiting, 307. 

Waking, 154, 155, 327; match, 161. 

Wart, 348. 

Washing, 158, 186. 

Washington city, 17, 145, 241, 242, 243. 

Washington state, 42, 216. 

Water cooler, 258. 

Weights and measures, 85. 

Wells, 44, 45, 46, 48, 49, 54, 250. 

Wheat, 96, 103, 104, 105. 

Whiskey, 171, 310. 

White blood cells, 9, 11, 15, 16, 37, 125, 

171, 278, 287, 288, 294, 302, 312. 
Whooping cough, 122, 123, 258. 
Wiley, Dr., quoted, 105 
Window, 182, 206; box, 89; tent, 23, 24. 
Wind pipe, 332. 
Wine, 171. 
Winter, 22. 

Woman's health, 157, 317, 323, 328. 
Wood tick, 150. 
Worcester, 138. 
Work, 163, 300, 322. 
Working man, 5; woman, 2, 120, 266. 

X-rays, 107. 

Yeast plants, 12, 14. 
Yellow fever, 143, 144. 
Yuma Indians, 192. 



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